A combination of illness invalidation from the work environment and helplessness is associated with embitterment in patients with FM

作者：Blom David^*; Thomaes Sander; Kool Marianne B; van Middendorp Henriet; Lumley Mark A; Bijlsma Johannes W J; Geenen Rinie

来源：Rheumatology, 2012, 51(2): 347-353.

DOI：10.1093/rheumatology/ker342

• fibromyalgia
• work
• workload
• psychological adaptation
• embitterment
• resentment
• invalidation
• helplessness

Objectives. The aim of this study in employed people with FM was to test the hypothesis that embitterment is a function of the joint experience of invalidation from the work environment and helplessness regarding one%26apos;s illness. %26lt;br%26gt;Methods. Sixty-four full-time (36%) or part-time (64%) employed patients with FM (60 females, mean age 45 years) completed the Illness Invalidation Inventory (3*I) to assess work-related discounting and lack of understanding, the Illness Cognition Questionnaire (ICQ) to assess helplessness and the Bern Embitterment Inventory (BEI) to assess embitterment. Hierarchical regression analysis was performed. %26lt;br%26gt;Results. Sixteen percent of the participants experienced embitterment levels in the clinical range. The interaction or combination of discounting and helplessness (P = 0.02) and the combination of lack of understanding and helplessness (P = 0.04) were associated with greater embitterment. %26lt;br%26gt;Conclusions. The construct of embitterment has substantial face validity and may result from a combination of invalidation and helplessness. Whereas helplessness is a common target of cognitive-behavioural therapy, evidence-based interventions to redress invalidation and embitterment are needed. It is possible, however, to target invalidation by educating people in the work environment about the consequences of FM and patients%26apos; valid needs for work that is manageable, given each patient%26apos;s specific health-related limitations.

• 出版日期2012-2