• Aleksi Varinen, Tiina Vuorio, Elise Kosunen, and Tuomas H Koskela.
• Department of General Practice, Faculty of Medicine and Health Technology, Tampere University, Tampere, Finland.
• Eur J Gen Pract. 2022 Dec 1; 28 (1): 157-164.

BackgroundFibromyalgia is a functional syndrome. Despite recent findings, there is still considerable uncertainty about its diagnostic process.ObjectivesThis study aimed to explore patients' experiences with fibromyalgia during the diagnostic process in primary health care. Moreover, we tried to determine how diagnostic consultation could be improved.MethodsThis study is based on data from patients with fibromyalgia in a primary health care study conducted in Nokia, Finland. Patients with fibromyalgia were identified from electronic medical records. Focus-group participants with fibromyalgia diagnoses were selected using a purposive sampling method to gather a maximum variation sample. Qualitative thematic analysis was used for the coded data from four focus-group discussions in 2018. A description of the coding tree was provided and researchers organised the codes. Finally, all researchers identified themes from the data.ResultsThe main unifying entities were the uncertainty and contradictions fibromyalgia patients faced on several occasions. Physicians sometimes offered other diagnoses - like depression - as an explanation for the symptoms, or used repetitive tests to eliminate other possible diagnoses. Furthermore, patients expressed their wishes for a holistic, empathetic, and up-to-date approach to their symptoms.ConclusionIn our interviews, a good doctor-patient relationship and continuity of care were necessary, as were the physician's attitude and knowledge of fibromyalgia. Our findings also suggest avoiding repeated or unnecessary rule-out tests and the overdiagnosis of psychiatric disorders is necessary.

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