Walter Suzy
Questions or comments about this article may be directed to Suzy Walter, PhD FNP-BC CNRN, at
J Neurosci Nurs. 2014 Dec;46(6):337-50. doi: 10.1097/JNN.0000000000000095.
This study describes a multivariate model showing how lifestyle behaviors (skipping meals, water intake, tobacco use, alcohol use, and physical activity) and illness-related factors (depression, somatic complaints, insomnia, and obesity) work together to predict headache in an adolescent population.
A descriptive, cross-sectional, secondary analysis using survey data from the National Longitudinal Study of Adolescent Health (1996) is reported. The National Longitudinal Study of Adolescent Health is a large database providing a nationally representative sample of adolescents (aged 11-17 years, n = 13,570). The database evaluated adolescent headache and is inclusive of all the predictors specific to this study. Frequency analysis and forward logistic regression were performed using each of the lifestyle behaviors and illness-related factors.
Approximately 26% of the adolescents experienced recurrent headache. Recurrent headache was reported by 19% of male adolescents and 26% of female adolescents. A multivariate model was developed that showed how lifestyle behaviors and illness-related factors predict recurrent headache in adolescents. The final model (Wald F = 86.88, p = .00) consisted of the following predictors: chest pain, muscle and joint pain, skip breakfast three or more times a week, skip lunch one or more times a week, and physical activity. The interactions of gender and age group, race and smoking regularly, and depression and insomnia were also included in the final model.
Providing evidence to clinicians that lifestyle behaviors and illness-related factors are associated with adolescent headache may improve overall headache assessment and may result in a more comprehensive plan of treatment.
本研究描述了一个多变量模型,该模型展示了生活方式行为(不规律饮食、饮水量、吸烟、饮酒和体育活动)以及与疾病相关的因素(抑郁、躯体不适、失眠和肥胖)如何共同作用以预测青少年群体中的头痛情况。
报告了一项描述性、横断面的二次分析,该分析使用了来自青少年健康全国纵向研究(1996年)的调查数据。青少年健康全国纵向研究是一个大型数据库,提供了具有全国代表性的青少年样本(年龄在11 - 17岁之间,n = 13570)。该数据库评估了青少年头痛情况,并包含了本研究所有特定的预测因素。对每种生活方式行为和与疾病相关的因素进行了频率分析和向前逻辑回归分析。
约26%的青少年经历过复发性头痛。19%的男性青少年和26%的女性青少年报告有复发性头痛。建立了一个多变量模型,展示了生活方式行为和与疾病相关的因素如何预测青少年的复发性头痛。最终模型(Wald F = 86.88,p = .00)由以下预测因素组成:胸痛、肌肉和关节疼痛、每周三次或更多次不吃早餐、每周一次或更多次不吃午餐以及体育活动。最终模型还包括性别与年龄组、种族与经常吸烟以及抑郁与失眠之间的相互作用。
向临床医生提供证据表明生活方式行为和与疾病相关的因素与青少年头痛有关,可能会改善整体头痛评估,并可能导致更全面的治疗方案。