{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2023,10,4]],"date-time":"2023-10-04T07:19:33Z","timestamp":1696403973099},"reference-count":55,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2014,12,10]],"date-time":"2014-12-10T00:00:00Z","timestamp":1418169600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"Swiss National Research Foundation","award":["4053-104645"],"award-info":[{"award-number":["4053-104645"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Health Expectations"],"published-print":{"date-parts":[[2015,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Fibromyalgia is characterized by chronic widespread pain and various associated symptoms, including psychological distress. This study presents a secondary analysis of the interviews of patients with fibromyalgia to appraise the affective load of the patient narratives as assessed by independent clinicians.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and participants<\/jats:title><jats:p>Three clinicians, an internist, a psychiatrist and a psychologist, who were experienced in chronic pain reviewed the interview transcripts of 56 women eliciting their views regarding fibromyalgia onset. A Clinical Global Impression (<jats:styled-content style=\"fixed-case\">CGI<\/jats:styled-content>) scale was used (0\u00a0=\u00a0no affective load to 5\u00a0=\u00a0maximum affective load) to provide a subjective appraisal of the intensity of the affective impact, as suggested in the transcripts and from the clinician perspectives.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The mean affective load was 3.6 (<jats:styled-content style=\"fixed-case\">SD<\/jats:styled-content>\u00a0=\u00a0\u00b11), indicating the perception of a high affective load in the clinicians. Values indicating a high or very high affective load (\u22654 points on the <jats:styled-content style=\"fixed-case\">CGI<\/jats:styled-content> scale) were more frequent than those in the lower range [23 narratives (41%) vs. 3 (5%)]. The inter\u2010rater agreement of the affective load of the narratives was high (<jats:italic>K<\/jats:italic>\u00a0&gt;\u00a00.85). These results of the clinician perspectives parallel those of the patient narratives, emphasizing disruptive circumstances, psychological distress and hopelessness surrounding symptom onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The affective load in the narratives of these patients with fibromyalgia was high and had a negative undertone when considered from the clinicians' perspective. This study highlights the importance of considering the affective resonance in the context of therapeutic relationships that are often emotionally laden and highly challenging for the clinician.<\/jats:p><\/jats:sec>","DOI":"10.1111\/hex.12323","type":"journal-article","created":{"date-parts":[[2014,12,10]],"date-time":"2014-12-10T15:13:23Z","timestamp":1418224403000},"page":"3325-3335","source":"Crossref","is-referenced-by-count":0,"title":["Assessing the affective load in the narratives of women suffering from fibromyalgia: the clinicians' appraisal"],"prefix":"10.1111","volume":"18","author":[{"given":"Christine","family":"Cedraschi","sequence":"first","affiliation":[{"name":"Division of General Medical Rehabilitation Geneva University Hospitals and University of Geneva Geneva Switzerland"},{"name":"Division of Clinical Pharmacology and Toxicology Multidisciplinary Pain Centre Geneva University Hospitals and University of Geneva Geneva 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