A Feminist, Biopsychosocial Subjective Well-Being Framework for Women With Fibromyalgia

Objective: To explore the biopsychosocial predictors of subjective well-being (SWB) in women with fibromyalgia syndrome (FMS) through a framework informed by feminist disability theory. Method: Two hundred twenty-nine women with FMS completed an online survey measuring FMS severity, physician-patient working alliance, meaningful role-functioning, illness centrality, and SWB. Structural equation modeling was used to determine the relationships among the constructs and their statistical contributions to SWB. Several open-ended prompts were used to inform the quantitative results. Results: The results indicated a good fit between the data and the respecified model. All variables significantly contributed to the overall model. FMS severity, meaningful role-functioning, and illness centrality accounted for 79% of the variance in SWB, with the indirect effect of physician-patient working alliance. Conclusion: The present study provided strong support for a biopsychosocial framework encompassing the medical environment, FMS severity, illness centrality, and meaningful role-functioning to predict SWB in women with FMS. As a feminist framework, the primary research model needs further refinement but still has significant implications for conceptualization, treatment, and future research. Impact and Implications This work expands upon the extant literature concerning the biopsychosocial underpinnings of subjective well-being in persons with fibromyalgia, specifically focusing on the intersection of gender and disability. This study provides context for evaluating subjective well-being in persons with disabilities through a feminist, biopsychosocial framework of chronic illness and disability. Future research should focus efforts on developing scales that capture the gendered experiences of women and women with disabilities in health care settings.