{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:11:41Z","timestamp":1788433901113,"version":"build-2803163510"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2024,1,29]],"date-time":"2024-01-29T00:00:00Z","timestamp":1706486400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Journal of Clinical Nursing"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Aims<\/jats:title><jats:p>To investigate the relationships between depression symptoms, perceived stigma, disease severity, patient\u2010provider communication and medication adherence in fibromyalgia patients. The objectives were to explore how these factors influence treatment adherence and to develop a comprehensive model illustrating their interconnections.<\/jats:p><\/jats:sec><jats:sec><jats:title>Background<\/jats:title><jats:p>Fibromyalgia is a chronic pain syndrome with fatigue, sleep issues and idiopathic pain. Medication adherence is limited by insufficient symptom relief, side effects and costs. Stigma further complicates fibromyalgia. Disease severity affects patient\u2010provider communication. Associations between depression, stigma, severity, communication and adherence in fibromyalgia are unclear.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A cross\u2010sectional, correlational study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The STROBE guidelines for cross\u2010sectional studies were followed. Participants included Hebrew\u2010speaking participants who were members of two Facebook groups: \u2018Shades of Purple\u2019 and \u2018Fibromyalgia\u2010 Get to Know!\u2019 Between February and April 2022. They undertook evaluations using The Patient Health Questionnaire\u20109 to gauge depression symptoms, assessed perceived stigma, utilised The Revised Fibromyalgia Impact Questionnaire to determine disease severity, employed The Patient Reaction Assessment questionnaire for patient\u2010provider communication, and used the 8\u2010item Morisky Medication Adherence Scale (MMAS\u20108). Associations between the variables were explored using Pearson's correlations and path analyses.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The study included 141 women with fibromyalgia, aged 22 to 76\u2009years. Most reported having a stable partner (69.5%) and 75.2% had children. The treatment adherence levels were as follows: 53.2% (<jats:italic>N<\/jats:italic>\u2009=\u200975)\u2014low, 33.3% (<jats:italic>N<\/jats:italic>\u2009=\u200947)\u2014medium and 13.5% (<jats:italic>N<\/jats:italic>\u2009=\u200919)\u2014high. Depression positively correlated with stigma. Stigma negatively correlated with patient\u2010provider communication. Patient\u2010provider communication positively correlated with treatment adherence. A significant negative indirect effect of depression on treatment adherence through stigma and patient\u2010provider communication was found.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Perceived stigma and patient\u2010provider communication played a mediating role in the relationships between depression and treatment adherence among women with fibromyalgia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Relevance to Clinical Practice<\/jats:title><jats:p>Addressing stigma related to fibromyalgia and effective patient\u2010provider communication can positively influence treatment adherence.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patient or Public Contribution<\/jats:title><jats:p>No patient or public 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