Background: Fibromyalgia patients suffer from widespread chronic pain throughout the musculoskeletal system. There are no apparent clinical visible symptoms, and the syndrome lacks a clear medical explanation. Female fibromyalgia patients often feel they suffer from a transparent disease which is not acknowledged as an illness by their social circle. Hence, they are often exposed to skeptics and critics. One of the challenges fibromyalgia patients faces is to convince their surroundings that they are in pain and accept the presence of the invisible disease and the chronic pain in their lives. A multidisciplinary Fibrotherapy treatment model, implemented at the Ezra Le'Marpeh Rehabilitation Center, supports female fibromyalgia patients through a holistic mind-body approach, delivered in three 10-week cycles totaling 30 weeks of treatment. The research aims to understand the experiences of female fibromyalgia patients who perceive themselves as suffering from an invisible disease and the personal and familial aspects of transitioning from lack of acceptance to coping with reality and adaptation. Methods: We interviewed 16 female fibromyalgia patients in Israel and qualitatively analyzed the data using the Grounded Theory approach. Results: Following participation in the program, the fibromyalgia patients accepted the presence of the disease in their lives and changed their attitude toward the disease and its consequences. Conclusions: As fibromyalgia symptoms are invisible and can suddenly burst into their lives without warning, female fibromyalgia patients often face skepticism from their social circle and have self-doubt. Therefore, participating in holistic intervention programs may improve how they accept the disease and come to terms with its existence by taking a proactive coping approach.

Adverse medical events not only harm patients and families, but also cause significant negative impact on healthcare providers, with potential to compromise future professional functioning. These “second victims” may need organizational support and rehabilitation to return to functionality. We analyzed the validity of an adapted tool, the Second Victim Experience and Support Tool (SVEST), to a population in Israel, H-SVEST. The H-SVEST was completed by 172 nurse participants working in a variety of patient care settings. The H-SVEST was assessed for content validity, internal consistency, and construct validity with confirmatory factor analysis (CFA). The CFA run on the initial model with 10 factors and 36 items did not meet criteria for goodness of fit. After removing five items based on their low factor loadings and the correlation, The model fit significantly improved with acceptable CFI, TLI, RMSEA, and SRMR; χ2(389) =626.939, p<.001; χ2/df=1.61; TLI=0.901; CFI=0.917; RMSEA [90% CI]=0.060 [0.051, 0.068]; SRMR=0.064. The final version included 31 items and 10 factors with Cronbach α values ranging from 0.66 to 0.94. The H-SVEST demonstrates robust psychometric properties and valuable insights into the second victim experience in the Israeli context. Comparative analysis with other versions highlights potential cultural influences and areas for further investigation. Implementing this tool and developing evidence-based interventions based on its results can significantly improve well-being and resilience of healthcare providers in Israel and other countries with diverse cultural populations. This study was not registered.