Nicholson Robert, Nash Justin, Andrasik Frank
St.Louis University School of Medicine, Community and Family Medicine, St. Louis, MO 63104, USA.
Headache. 2005 Oct;45(9):1124-39. doi: 10.1111/j.1526-4610.2005.00236.x.
The objective of this study was to evaluate the effectiveness of a Self-Administered Behavioral Intervention using Tailored messages (SEABIT) for migraine. The primary measures were headache days, headache-related disability, behavioral/emotional factors, and headache-related beliefs.
Behavioral and cognitive-behavioral interventions for migraine treatment are well established and possess "Grade-A" evidence based on the U.S. Headache Consortium evidence-based guidelines. To increase the accessibility of behavioral interventions in primary and other settings, treatment can be delivered in self-administered formats. Incorporating tailored health communication strategies (via tailored messages) into a self-administered format can help maintain a level of personalization without requiring regular visits to a behavioral specialist. Tailored messages are created using individual-level assessment data to educate and motivate the patient to develop behavioral skills and strategies for migraine prevention and management.
Twenty-five individuals (95% female, 90% Caucasian, mean headache years = 21.0) began and 84% (21/25) completed all phases of the 8-week SEABIT developed for migraine prevention (preceded by a 1-month baseline phase and followed by a 1-month postintervention phase).
Overall, 62% (13/21) reported at least a 50% reduction in headache frequency, and mean headache frequency for the group was also significantly reduced from baseline to postintervention (16.9 vs. 10.7, P < .001; eta2= .61). Headache-related disability, behavioral/emotional factors, and headache-management self-efficacy also showed significant improvement.
The findings suggest that the SEABIT for migraine prevention is an effective behavioral intervention that potentially could be accessed and distributed in a variety of settings including primary care.
本研究旨在评估使用定制信息的自我管理行为干预(SEABIT)对偏头痛的有效性。主要测量指标为头痛天数、与头痛相关的残疾、行为/情绪因素以及与头痛相关的信念。
偏头痛治疗的行为和认知行为干预已得到充分确立,并且根据美国头痛协会循证指南拥有“A级”证据。为了提高在初级保健和其他环境中行为干预的可及性,可以采用自我管理的形式进行治疗。将定制的健康沟通策略(通过定制信息)纳入自我管理形式有助于保持个性化程度,而无需定期拜访行为专家。定制信息是利用个体水平的评估数据创建的,用于教育和激励患者培养预防和管理偏头痛的行为技能及策略。
25名个体(95%为女性,90%为白种人,平均头痛年限 = 21.0)开始参与为预防偏头痛而制定的为期8周的SEABIT干预(之前有1个月的基线期,之后有1个月的干预后期),84%(21/25)完成了所有阶段。
总体而言,62%(13/21)报告头痛频率至少降低了50%,并且该组的平均头痛频率从基线期到干预后期也显著降低(16.9对10.7,P <.001;eta2 =.61)。与头痛相关的残疾、行为/情绪因素以及头痛管理自我效能也显示出显著改善。
研究结果表明,用于预防偏头痛的SEABIT是一种有效的行为干预,可能可以在包括初级保健在内的各种环境中获得和推广。