A randomized controlled trial of a wellness intervention for women with fibromyalgia syndrome.

OBJECTIVE: To examine the effects of a wellness intervention, Lifestyle Counts, for women with fibromyalgia syndrome on the level of self-efficacy for health-promoting behaviours, health-promoting activity and perceived quality of life. DESIGN: A randomized controlled single-blinded trial with treatment and attention-control groups. SETTING: Community in the southwestern United States. SUBJECTS: Convenience sample of 187 women (98 treatment, 89 attention control) with fibromyalgia syndrome (mean age = 53.08 years, SD 9.86). INTERVENTION: The two-phase Lifestyle Counts intervention programme included lifestyle change classes for eight weeks, with goal-setting and telephone follow-up for three months. Participants in the attention-control group were offered an equivalent amount of contact in classes on general disease-related information and health education topics and unstructured follow-up phone calls. Participants were followed for a total of eight months after baseline. OUTCOME MEASURES: Self-report instruments measuring self-efficacy for health behaviours, health-promotion behaviours and health-related quality of life (SF-36 and the Fibromyalgia Impact Questionnaire) were completed at baseline, two months (after the classes), five months (after telephone follow-up) and at eight months. RESULTS: Both groups improved significantly (P<0.05) over time on the measures of self-efficacy, health behaviours, fibromyalgia impact and quality of life. There were significant group x time interactions for scores on the Health Promoting Lifestyle II subscales of physical activity and stress management. CONCLUSIONS: The Lifestyle Counts wellness intervention holds promise for improving health-promoting behaviours and quality of life of women with fibromyalgia syndrome.

The use of goal attainment scaling to facilitate and assess individualized change in a wellness intervention for women with fibromyalgia syndrome.

PURPOSE: The authors examined goal achievement over an 8-month period in women with fibromyalgia participating in a holistic health promotion intervention using Goal Attainment Scaling. DESIGN: Descriptive. METHODS: Goal attainment was assessed by interviews at five points: baseline (retrospectively), immediately after the 8-week classes, at the middle and end of the telephone support period, and 3 months later. FINDINGS: The percentage of women who attained or exceeded their goals in the four health promotion areas of Lifestyle Adjustment, Physical Activity, Nutrition, and Stress Management increased from between 15% and 26% at the end of the classes to between 58% and 76% at the end of the telephone support period. Although scores declined somewhat in the following 3 months, at least 60% of the women continued to report behaviors at or above their goal level in all areas except Physical Activity. CONCLUSIONS: Goal Attainment Scaling, an individually determined measure of change, can effectively capture behavioral changes associated with a holistic health promotion intervention. A nurse facilitator, who not only understood the need for specific, measurable GAS but was also able to encourage and support women's identification of goals that were meaningful to them, was key to the positive findings observed here.