Forgiveness education in fibromyalgia: A qualitative inquiry

Loren L. Toussaint, Ann Vincent, Mary O. Whipple, Samantha J. McAllister, Dawn M. Finnie, Julie C. Hathaway, Terry H. Oh, Kevin C. Fleming, Kristin S. Vickers Douglas

Department of Psychology, Luther College, Decorah, USA.
Division of Health Care Policy and Research, Mayo Clinic, Rochester, USA.
Division of Health Care Policy and Research, Mayo Clinic, Rochester, USA; Department of Psychiatry and Psychology, Mayo Clinic, Rochester, USA.
Fibromyalgia and Chronic Fatigue Clinic, Mayo Clinic, Rochester, USA;.
Patient Education Research, Mayo Clinic, Rochester, USA.

DOI: 10.4236/pst.2014.21003                

Abstract

The purpose of this qualitative study was to assess perspectives on the acceptability and the potential applicability of a forgiveness education in patients with fibromyalgia. The concept and tools of forgiveness were presented to thirteen women (age: 40 - 54 years) with a previous diagnosis of fibromyalgia. Subjects participated in 1 of 2 focus groups following a 90-minute education session in which forgiveness was presented as an emotion-focused coping strategy to deal with interpersonal stressors. Qualitative assessment of focus group discussions reveals 3 themes: 1) forgiveness is healthy and reduces pain, 2) forgiveness is within a patient’s personal control, and 3) forgiveness education is similar to other types of patient education and is well received. Our results suggest that forgiveness education is acceptable and feasible in patients with fibromyalgia. This justifies further exploration of forgiveness as an emotion-focused self- management strategy to decrease psychological distress.

Keywords

Fibromyalgia; Forgiveness Intervention; Pain; Patient Education

Conflicts of Interest

The authors declare no conflicts of interest.

References

[1]	Arnold, L.M., Crofford, L.J., Mease, P.J., Burgess, S.M., Palmer, S.C., Abetz, L. and Martin, S.A. (2008) Patient perspectives on the impact of fibromyalgia. Patient Education and Counseling, 73, 114-120. http://dx.doi.org/10.1016/j.pec.2008.06.005
[2]	Asbring, P. and Narvanen, A.L. (2002) Women’s experiences of stigma in relation to chronic fatigue syndrome and fibromyalgia. Qualitative Health Research, 12, 148- 160.
[3]	Sturge-Jacobs, M. (2002) The experience of living with fibromyalgia: Confronting an invisible disability. Research and Theory for Nursing Practice, 16, 19-31. http://dx.doi.org/10.1891/rtnp.16.1.19.52994
[4]	Haugli, L., Strand, E. and Finset, A. (2004) How do patients with rheumatic disease experience their relationship with their doctors? A qualitative study of experiences of stress and support in the doctor-patient relationship. Patient Education and Counseling, 52, 169-174. http://dx.doi.org/10.1016/S0738-3991(03)00023-5
[5]	Thieme, K., Rose, U., Pinkpank, T., Spies, C., Turk, D.C. and Flor, H. (2006) Psychophysiological responses in patients with fibromyalgia syndrome. Journal of Psycho- somatic Research, 61, 671-679. http://dx.doi.org/10.1016/j.jpsychores.2006.07.004
[6]	Davis, M.C., Zautra, A.J. and Reich, J.W. (2001) Vulnerability to stress among women in chronic pain from fibromyalgia and osteoarthritis. Annals of Behavioral Medicine, 23, 215-226. http://dx.doi.org/10.1207/S15324796ABM2303_9
[7]	Worthington, E.L. and Scherer, M. (2004) Forgiveness is an emotion-focused coping strategy that can reduce health risks and promote health resilience: Theory, review, and hypotheses. Psychology and Health, 19, 385-405. http://dx.doi.org/10.1080/0887044042000196674
[8]	Waltman, M.A. (2002) The psychological and physiological effects of forgiveness education in male patients with coronary artery disease. University of Wisconsin, Madison, Waltman.
[9]	Harris, A.H., Luskin, F., Norman, S.B., Standard, S., Bruning, J., Evans, S. and Thoresen, C.E. (2006) Effects of a group forgiveness intervention on forgiveness, perceived stress, and trait-anger. Journal of Clinical Psychology, 62, 715-733. http://dx.doi.org/10.1002/jclp.20264
[10]	Wade, N.G., Worthington, E.L. and Meyer, J.E. (2005) But do they work? A meta-analysis of group interventions to promote forgiveness. In: Worthington, E.L., Ed., Hand- book of Forgiveness (pp. 423-439). Taylor & Francis.
[11]	Enright, R.D. and Fitzgibbons, R.P. (2000) Helping clients forgive: An empirical guide for resolving anger and restoring hope. American Psychological Association.
[12]	McCullough, M.E. and Worthington, E.L. (1995) Promoting forgiveness: A comparison of two brief psychoeducational group interventions with a waiting-list control. Counsenling and Values, 40, 55-68. http://dx.doi.org/10.1002/j.2161-007X.1995.tb00387.x
[13]	Luskin, F. (2002) Forgive for good: A proven prescription for health and happiness. Harper, San Francisco.
[14]	Toussaint, L., Overvold-Ronningen, M., Vincent, A., Lue- dtke, C., Whipple, M., Schriever, T. and Luskin, F. (2009) Implications of forgiveness enhancement in patients with fibromyalgia and chronic fatigue syndrome. Journal of Health Care Chaplaincy, 16, 123-139. http://dx.doi.org/10.1080/08854726.2010.492713
[15]	Worthington, E.L. (2008) Steps to reach forgiveness and to reconcile. Pearson Learning Solutions, Boston.
[16]	Krueger, R.A. and Casey, M.A. (2009) Focus groups: A practical guide for applied research. 4th ed., Sage Publications, Los Angeles.
[17]	Patton, M.Q. (1990) Qualitative evaluation and research methods. 2nd ed., Sage Publications, Newbury Park.