Supporting behavioural self-management is increasingly important in the care for chronic widespread pain (CWP), including fibromyalgia. Understanding peoples' experiences of these interventions may elucidate processes and mechanisms that lead to or hinder their intended impact. We conducted a systematic review and thematic synthesis of qualitative studies exploring peoples' experiences of self-management interventions for CWP, including fibromyalgia. MEDLINE, Embase, PsycINFO, CINAHL, and Web of Science were searched. Primary qualitative or mixed-methods studies were included if they explored people's self-management intervention experiences for their CWP, including fibromyalgia. Screening, data extraction, and critical appraisal were conducted by 2 reviewers. Data analysis was conducted through thematic synthesis. Twenty-three studies were included, mostly were rated as high or moderate quality. We developed 4 analytic themes: A multifaceted experience of the intervention, potential for transformative experience of group cohesion, a new outlook, and striving for change after the loss of support. Broadly, personalisation was perceived as beneficial and people experienced a range of emotional experiences. These appeared to support positive behavioural and cognitive changes. For most, group activities promoted acceptance and support, fostering new perspectives and improved self-management, although some found aspects of group contexts challenging. Lack of on-going support after interventions led to challenges in applying behavioural strategies, and some struggled without social support from the group. The experiences of self-management interventions for CWP reflect a complex, multifaceted process. Although many reported positive experiences, addressing issues with integration of physical activity, group dynamics and postintervention support may improve effectiveness for a broader range of people.

中文翻译：

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包括纤维肌痛在内的慢性广泛疼痛的自我管理干预措施：系统评价和定性证据综合。


支持行为自我管理在治疗慢性广泛性疼痛 (CWP)（包括纤维肌痛）方面变得越来越重要。了解人们对这些干预措施的体验可以阐明导致或阻碍其预期影响的过程和机制。我们对定性研究进行了系统回顾和主题综合，探索人们对 CWP（包括纤维肌痛）进行自我管理干预的经验。检索了 MEDLINE、Embase、PsycINFO、CINAHL 和 Web of Science。如果主要定性或混合方法研究探讨了人们对其 CWP 的自我管理干预经验（包括纤维肌痛），则纳入其中。筛选、数据提取和严格评估由 2 名评审员进行。通过主题综合进行数据分析。纳入了二十三项研究，大部分被评为高质量或中等质量。我们制定了 4 个分析主题：干预的多方面体验、群体凝聚力变革体验的潜力、新的前景以及在失去支持后争取变革。从广义上讲，个性化被认为是有益的，人们会经历一系列的情感体验。这些似乎支持积极的行为和认知变化。对于大多数人来说，团体活动促进了接受和支持，培养了新的视角并改善了自我管理，尽管有些人发现团体环境的某些方面具有挑战性。干预后缺乏持续的支持导致行为策略的应用面临挑战，有些人在没有团体社会支持的情况下陷入困境。 CWP 自我管理干预的经验反映了一个复杂、多方面的过程。 尽管许多人报告了积极的经历，但通过整合体育活动、团体动力和干预后支持来解决问题可能会提高更广泛人群的有效性。