Nurse Educator M.S.

Year Approved


First Advisor

Meyer, Kimberley


Background: Women with fibromyalgia (FM) experience a range of symptoms threatening the integrity of their overall wellbeing. Since no cure exists, management to reduce symptoms, disability, and improve functionality is the focus. Promising outcomes have been demonstrated when cognitive behavioral therapy (CBT) is used as a complementary measure to other treatments to increase an individual’s coping mechanisms through various exercises. Purpose: The Theory of Unpleasant Symptoms (TOUS), introduced by Elizabeth Lens and colleagues in 1995, provided a guiding framework to evaluate the effectiveness of multidisciplinary therapy with CBT in controlling influencers of pain and general symptom intensity. Results: Nineteen studies comparing a multi-method intervention involving CBT to controls without it were evaluated. In the end, a multi-method approach involving CBT was slightly to moderately superior to controls in reducing pain and improving mental functioning, particularly studies utilizing CBT, exercise and medication. Conclusions: This review and synthesis supports previous conclusions about CBT’s role in chronic pain management. Additional research on interventions developed in accordance with TOUS’ core concepts is necessary to determine its efficacy in the management of chronic pain disorders such as FM. Implications for Research and Practice: Providers must recognize all modifiable factors that influence an individual’s symptom experience. TOUS can serve as a guiding framework in identifying these, while facilitating in the development of sound interventions aimed at minimizing or alleviating their impact.

Degree Name

M.S. Nurse Educator

Document Type

Masterʼs thesis

Included in

Nursing Commons