Relationship between anxiety, post‐traumatic stress, insomnia and fibromyalgia among female refugees in jordan: A cross‐sectional study
Authors: Al‐Smadi Ahmed Mohammad , Tawalbeh Loai Issa , Gammoh Omar Salem , Ashour Ala Fawzi , Shajrawi Abedalmajeed , Attarian Hrayr 
Published: January 2021

Accessible summaryWhat is known on the subject?

Fibromyalgia (FM) is a syndrome of chronic widespread pain, typically associated with fatigue, sleep, cognitive dysfunction and disordered mood.

FM may limit an individual's ability to participate in everyday work and social activities, thereby making it difficult to maintain normal relationships with other individuals.

While it has been studied in different populations and settings, the impact of FM and associated psychological factors has not been previously studied among female war refugees.

What does the paper add to existing knowledge?

The study showed the high impact of FM on female refugees in Jordan; approximately three quarters of the participants had a moderate to severe FM impact.

Refugees settled in Irbid city, Iraq, showed increased age, anxiety and post‐traumatic stress disorder correlated with a higher FM impact.

What are the implications for practice?

The study recommends evaluation of the impact of FM among all female refugees living in Jordan, along with its neighbouring countries hosting refugees.

Healthcare providers, including mental health nurses, should be aware of the role of PTSD and anxiety on the impact of FM. Accordingly, healthcare workers should design appropriate mental health treatment plans to help to decrease the impact of FM.

Mental health nurses should evaluate FM impact among all refugees worldwide. Nurses in Jordan are recommended to share their experience with nurses outside of Jordan as this may help with funds being obtained and the implementation of advanced psychological interventions.

AbstractIntroductionFibromyalgia (FM) is a syndrome of chronic widespread pain. While it has been studied in different populations and settings, the impact of FM and its associated psychological factors has not been previously studied among female war refugees.AimTo assess the impact of FM and its associated factors in female refugees.MethodsA cross‐sectional study was conducted. The impact of FM, anxiety, post‐traumatic stress (PTSD) and insomnia was investigated.Results288 refugees previously diagnosed with FM were recruited. The results showed that 73.62% of the participants had a moderate to severe FM impact. Refugees settled in Irbid city were six times more likely to have a higher FM impact than refugees settled in Zarqa, and Iraqi refugees were more likely to have a higher impact than Syrian. Increased age, anxiety and PTSD were correlated with a greater impact.ConclusionMental health nursing services should be directed towards female refugees, particularly those with increased age, anxiety and PTSD.Implications for practiceMental health nurses should evaluate the FM impact among all refugees worldwide. Furthermore, nurses in Jordan are recommended to share their experiences with nurses outside of Jordan, as this may help to raise funds and implement advanced psychological interventions.