Resilience and Sense of Coherence among Female Fibromyalgia Patients Living in a Conflict Zone Who Underwent Fibrotherapy Intervention

Objective: This study sought to examine whether the sense of coherence (SoC) and resilience among female fibromyalgia (FM) patients increased after participation in a fibrotherapy intervention program (FTI) and whether SoC and resilience increased among female FM patients (FFMPs) exposed to security threats who changed their coping strategies to problem-oriented coping. Methods: Ninety-six FFMPs aged 19–75 enrolled in the FTI program led by Rabbi Firer in Sderot, Israel. The intervention program is divided into three stages, each comprising a distinct weekly treatment plan. The treatment plans encompass the following modalities: physiotherapy adapted to FM conditions, group therapy, hydrotherapy, horticultural therapy/cooking therapy, Pilates, pottery therapy, and kundalini yoga. Each stage spans a duration of 10 weeks, culminating in a total program duration of 30 weeks. Results: The findings show that after participating in FTI, the problem-orientation level of coping and health indicators, including functional ability and physiological scores (pre- and post-exertion), increased while psychological distress levels decreased. Overall, all the physiological scales measured before and after the FTI showed a significant improvement among the entire sample. FFMPs with problem-oriented strategies reported higher levels of SoC and resilience after participating in the FTI program. Conclusions: The FTI provided FFMPs with tools to understand the meaning of their disease and its management, whereas before they were preoccupied with the presence of the disease and its negative impact on their lives. The participation of FFMPs in the FTI leads to a perceptual change, the adoption of problem-oriented coping strategies, and the increased utilization of coping resources, namely, SoC and resilience. Problem-oriented coping combined with high SoC and resilience led FFMPs to adopt health strategies such as physical activity and other empowering activities that raised their physical and mental health indicators.