Hung Pei-Hua, Fuh Jong-Ling, Wang Shuu-Jiun
The Neurological Institute, Taipei Veterans General Hospital and National Yang-Ming University School of Medicine, Taipei, Taiwan.
Acta Neurol Taiwan. 2006 Mar;15(1):43-8.
Migraine is a recurring and disabling pain disorder. The prevalence is estimated as 9.1% in Taiwan. Patients suffer from significant loss of work, time at school or ability to perform household chores, as well as other family or leisure activities. Treatment strategies during migraine attacks should be tailored based on the severity of disability. Stewart and Lipton (1999) developed the Migraine Disability Assessment Questionnaire (MIDAS) to assess the severity of disability related to migraine. This simple, self-administered, 7-item questionnaire focuses on disability in three domains (school or paid work, household chores, and family, social, or leisure activities) in the first 5 items of the questionnaire. The internal consistency, test-retest reliability, validity, ease of use, and clinical utility were all tested with good results. The questionnaire offers a simple tool to improve physician-patient communication. As for treatment strategies, a recent large-scale study done in the USA showed that it is more efficacious to treat migraine patients by adopting a strategy of stratified care based on different disability status than a stepped-care strategy. The simple questionnaire, MIDAS, has received world-wide popularity and has been translated into Japanese, Italian and Turkish. All of these versions showed good reliability and validity. Recently, one of our studies demonstrated that the Taiwan version also yielded comparable internal consistency, reliability, and validity. We hope that the MIDAS questionnaire can be widely adopted in Taiwan to help physicians assess their patients' disability related to migraine and provide clues for clinical management.
偏头痛是一种反复发作且使人丧失能力的疼痛性疾病。据估计，台湾地区的患病率为9.1%。患者在工作、上学时间或进行家务劳动以及其他家庭或休闲活动方面遭受严重损失。偏头痛发作期间的治疗策略应根据残疾的严重程度进行调整。斯图尔特和利普顿（1999年）开发了偏头痛残疾评估问卷（MIDAS），以评估与偏头痛相关的残疾严重程度。这份简单的、可自行填写的7项问卷在前5项中重点关注三个领域的残疾情况（学校或有偿工作、家务劳动以及家庭、社交或休闲活动）。对其内部一致性、重测信度、效度、易用性和临床实用性均进行了测试，结果良好。该问卷为改善医患沟通提供了一个简单工具。至于治疗策略，美国最近进行的一项大规模研究表明，根据不同残疾状况采用分层护理策略治疗偏头痛患者比阶梯式护理策略更有效。简单的MIDAS问卷在全球范围内广受欢迎，已被翻译成日语、意大利语和土耳其语。所有这些版本都显示出良好的信度和效度。最近，我们的一项研究表明，台湾版也具有相当的内部一致性、信度和效度。我们希望MIDAS问卷能在台湾广泛采用，以帮助医生评估患者与偏头痛相关的残疾情况，并为临床管理提供线索。
