Skomo Monica L, Desselle Shane P, Berdine Hildegarde J
Duquesne University, Mylan School of Pharmacy, Pittsburgh, PA, USA.
Headache. 2006 May;46(5):742-9. doi: 10.1111/j.1526-4610.2006.00431.x.
The purpose of this study was to identify factors that contribute to treatment-seeking behavior in migraineurs in a large employer population. Specifically, the impact of psychographic variables, such as social support, attitudes toward medication, locus of control, and migraine-associated disability, are considered concomitantly with demographic and disease severity variables.
Migraine remains an underconsulted condition. Previous explorations of demographic factors and headache characteristics have not adequately predicted migraineur physician-consulting behavior.
University employees and students experiencing headaches were interviewed by pharmacists to determine whether they suffer from migraine using the International Headache Society (IHS) criteria for migraine. Identified migraineurs were categorized into 3 groups: (1) never-consulter, (2) lapsed-consulter, and (3) current-consulter. Each group was asked to complete an instrument that assesses perceived social support (Headache Social Support Questionnaire), medication attitudes (Beliefs about Medicines Questionnaire), locus of control (Headache-Specific Locus of Control Scale), and migraine-associated disability (Migraine Disability Assessment Questionnaire). Univariate (ANOVA) and multivariate (logistic regression) approaches were used to identify factors associated with migraineur-consulting behavior.
A total of 100 subjects participated in the study. Eighty-two participants met IHS criteria for migraine, of whom 22 were never-consulters, 20 were lapsed-consulters, and 40 were current-consulters. The consulter groups differed on scores acquired from the Social Support Active Involvement subscale (P= .04) and the Healthcare Professional Locus of Control subscale (P= .010). The logistic regression procedures confirmed the contributions of social support and healthcare locus of control in predicting migraineur-consulting behavior.
Results suggest that attitudes concerning the role of healthcare professionals and the presence of a supportive social network have greater influence on migraineur-consulting behavior than do patient demographic characteristics, beliefs about medications, and migraine frequency and severity. With an understanding of the link between psychosocial variables and consulting behavior, healthcare professionals may be able to positively impact migraineur physician consultation rates, drug therapy, and quality of life.
本研究旨在确定在一大群受雇人员中促使偏头痛患者寻求治疗行为的因素。具体而言，将心理特征变量（如社会支持、对药物的态度、控制点和偏头痛相关残疾）的影响与人口统计学和疾病严重程度变量一并考虑。
偏头痛仍然是一种咨询不足的疾病。先前对人口统计学因素和头痛特征的探索未能充分预测偏头痛患者的就医行为。
药剂师对有头痛症状的大学员工和学生进行访谈，根据国际头痛协会（IHS）的偏头痛标准确定他们是否患有偏头痛。确定的偏头痛患者分为三组：（1）从未就医者，（2）曾就医但已不再就医者，（3）目前仍在就医者。每组都被要求完成一份评估感知社会支持（头痛社会支持问卷）、药物态度（药物信念问卷）、控制点（头痛特异性控制点量表）和偏头痛相关残疾（偏头痛残疾评估问卷）的工具。采用单变量（方差分析）和多变量（逻辑回归）方法来确定与偏头痛患者就医行为相关的因素。
共有100名受试者参与了研究。82名参与者符合IHS偏头痛标准，其中22名从未就医，20名曾就医但已不再就医，40名目前仍在就医。就医组在社会支持积极参与子量表（P = 0.04）和医疗保健专业人员控制点子量表（P = 0.010）上的得分存在差异。逻辑回归程序证实了社会支持和医疗保健控制点在预测偏头痛患者就医行为方面的作用。
结果表明，与患者的人口统计学特征、对药物的信念以及偏头痛的频率和严重程度相比，对医疗保健专业人员作用的态度和支持性社会网络的存在对偏头痛患者的就医行为影响更大。了解心理社会变量与就医行为之间的联系后，医疗保健专业人员或许能够对偏头痛患者的就医率、药物治疗和生活质量产生积极影响。
