Avaliação de um programa de educação em saúde para pacientes com fibromialgia: inserção de práticas integrativas e complementares e sua relação com os níveis de autocuidado, estresse, depressão e ansiedade

Abstract

Fibromyalgia (FM) is a chronic, multifactorial and degenerative rheumatological condition that substantially compromises individuals' quality of life, resulting in functional incapacity and cognitive and mental suffering. It is also a predisposing factor for the development of anxiety, depression and stress. Although fibromyalgia is recognized as a disease that requires a comprehensive and interdisciplinary approach, traditional treatment strategies still focus on unidisciplinary and passive models. In this context, the aim of this study was to evaluate the effect of a health education program (FloreSer), with the inclusion of Integrative and Complementary Health Practices (ICPs), in relation to levels of self-care, stress, depression and anxiety in patients with fibromyalgia. The methodology consisted of a randomized clinical trial involving 21 patients, divided into an Intervention Group (IG) with 12 patients and a Control Group (CG) with 9 patients. The IG underwent a protocol of 12 weekly meetings, with the insertion of PICS and interviews applied at the beginning and end of the period, while the CG participated only in the interviews and had their data collected at the same time interval. The assessment tools included the Self-Care Agency Assessment Scale Revised (EAAA-R), the Stress Perception Scale-10 (EPS-10), the Beck Anxiety Scale (BAI) and the Beck Depression Scale (BDI-II). Quantitative data was analyzed using Pearson's and Spearman's correlation coefficients, and differences with p < 0.05 were considered significant. In analyzing the results,

the comparison between moments showed that the GI had a significant improvement in self- care levels (p = 0.008), as measured by the EAAA-R, and a reduction in the EPS-10, BAI and

BDI-II scores. However, only the latter showed a statistically significant difference (p = 0.045) and a change in category after the intervention (from moderate depression at the start to mild depression at the end). The comparison between groups revealed a significant change only in the EPS score (p = 0.024). The intervention resulted in a positive difference in the self-care and depression scores (between moments) and in the stress score (between groups). There was no change in the anxiety factor (between moments and/or between groups). These findings suggest that the proposed intervention model can be replicated in public health contexts and in the private sector, as it offers an interdisciplinary, patient-centered treatment with the potential to improve the quality of life of people with fibromyalgia.