Mapping the Social Organisation of Neglect in the Case of Fibromyalgia: Using Smith's Sociology for People to Inform a Systems-Focused Literature Review.

Abstract

Fibromyalgia is a syndrome characterised by persistent unexplained pain and fatigue. People with fibromyalgia report receiving little support to manage symptoms, difficult interactions with healthcare practitioners and stigma associated with this contested condition. In this article, we employ Dorothy E Smith's Sociology for People to undertake a systems-focused literature review from the standpoint of people with fibromyalgia, moving beyond individual subjectivities to map how problems are socially organised. This is a novel application of a Sociology for People which, although previously used to structure research projects, has not previously been reported as a framework for literature review. Our findings highlight how, within a biomedically orientated healthcare system, practitioners' activities are organised to withdraw support from people with fibromyalgia and characterise problems as "psychological". Those looking to make service improvements for this patient group need to specifically challenge biomedical systems and ideology, in order to promote alternative models of care. We highlight a Sociology for People as a powerful lens for systems-focused literature review that links frontline experiences with dominant power relations, and provides an alternative to traditional qualitative evidence syntheses. Additionally, the theoretically-grounded and creative use of published literatures is an ethical approach adding value to extant research.