Why people with fibromyalgia persist in activity despite the increasing pain? A Delphi Study of the content of the Clinic Scale of Persistence in Activity in Fibromyalgia

Abstract

Background and objective: There is evidence of the relevance of fear, anxiety and avoidance of activity in the maintenance of pain in fibromyalgia. Recently, an opposite pattern based on the persistence in activity has been described. To date, the cognitions that impede modifying this pattern are unknown. Therefore, the aim of this study is to reach consensus on the content of an instrument that assesses those cognitions.

Material and methods: A Delphi method was applied to reach consensus on the content of the Clinic Scale of Persistence in Activity in Fibromyalgia (CCAP-FM).

Results: After three rounds of consultation, an acceptable consensus was reached. Those items that received an average rating of relevance lower than 5/10 and that at least the 75% of experts recommended removing were excluded. The preliminary questionnaire of persistence in activity was composed of 30 items.

Conclusions: The consensus on the content of the CCAP-FM will allow advancing towards the assessment of the relation between the modification of the cognitions responsible for the maintenance of the persistence in activity and the clinical improvement in people with fibromyalgia.