通过生活方式改变管理慢性每日头痛及精神共病：结合新传播媒介的参与式行动研究

Management of Chronic Daily Headache and Psychiatric Co-Morbidities by Lifestyle Modification: Participatory Action Research Combining New Communication Media.

作者信息

Faizi Fakhrudin, Tavallaee Abbas, Rahimi Abolfazl, Saghafinia Masoud

机构信息

PhD Candidate in Pain Research and Management, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

Associate Professor in Psychiatry, Behavioral Sciences Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.

出版信息

Anesth Pain Med. 2017 Jan 23;7(2):e42782. doi: 10.5812/aapm.42782. eCollection 2017 Apr.

DOI:10.5812/aapm.42782

PMID:28920050

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC5594418/

Abstract

BACKGROUND

Lifestyle modification has a significant role in chronic daily headache (CDH) management. Participatory action research (PAR) can play an important role in managing chronic medical conditions. However, it has been scarcely used in CDH management.

OBJECTIVES

This study aimed to empower patients with CDH to modify their lifestyle in order to reduce both their headache and related psychiatric co-morbidities in a multidisciplinary headache clinic at Baqiyatallah hospital, Tehran, IR Iran.

METHODS

In the PAR plan, 37 patients (27 females) diagnosed with CDH were selected using purposeful sampling. Along with face-to-face group sessions, all available communication means such as phone calls, emails, short message system (SMS), and social media (Telegram) were used to facilitate the process. Questionnaires of health promotion lifestyle profile (HPLPІІ), visual analog scale (VAS), and depression-anxiety-stress scale (DASS21) were used to collect data. The data were analyzed using SPSS software.

RESULTS

Mean age of the patients was 38.33 (± 9.7) years. Both "general pain" and "the worst imaginable pain" reduced (mean of reduction: 2.56 ± 2.7 and 2.3 ± 2.9, respectively, P < 0.001). > 50% of pain reduction occurred in "the worst imaginable pain" category (-1.45 ± 2.02, P < 0.001) and mean VAS score reduced to 5.20 (± 2.3) compared to the start of the study (7.50 ± 1.9, P < 0.001). Mean DASS-21 score also reduced significantly for depression (P < 0.016), anxiety (P < 0.026), and stress (P < 0.008). HPLPІІ score significantly improved (118.17 ± 14.8 vs. 160.83 ± 16.4, P < 0.001) and the highest increase was seen in the subscale of "stress management" (17.73 ± 2.8 vs. 25.53 ± 3.9, P < 0.001).

CONCLUSIONS

The empowering PAR plan combined with new communication tools helped the CDH patients better handle their lifestyle, reduce their headache, and lower their symptoms. Further studies with better use of currently available communication tools and social media are recommended for action research to be more applicable.

摘要

背景

生活方式的改变在慢性每日头痛（CDH）的管理中起着重要作用。参与式行动研究（PAR）在慢性疾病的管理中可以发挥重要作用。然而，它在CDH管理中很少被使用。

目的

本研究旨在使伊朗德黑兰巴基耶塔拉医院多学科头痛门诊的CDH患者有能力改变其生活方式，以减轻头痛及相关精神共病。

方法

在PAR计划中，采用目的抽样法选取37例被诊断为CDH的患者（27例女性）。除面对面小组会议外，还使用了所有可用的沟通方式，如电话、电子邮件、短信系统（SMS）和社交媒体（Telegram）来促进该过程。使用健康促进生活方式量表（HPLPІІ）、视觉模拟量表（VAS）和抑郁-焦虑-压力量表（DASS21）问卷收集数据。使用SPSS软件对数据进行分析。

结果

患者的平均年龄为38.33（±9.7）岁。“一般疼痛”和“最难以想象的疼痛”均有所减轻（平均减轻分别为：2.56±2.7和2.3±2.9，P<0.001）。超过50%的疼痛减轻发生在“最难以想象的疼痛”类别中（-1.45±2.02，P<0.001），与研究开始时相比，VAS平均评分降至5.20（±2.3）（7.50±1.9，P<0.001）。抑郁（P<0.016）、焦虑（P<0.026）和压力（P<0.008）的DASS-21平均评分也显著降低。HPLPІІ评分显著提高（118.17±14.8对160.83±16.4，P<0.001），“压力管理”子量表的增幅最大（17.73±2.8对25.53±3.9，P<0.001）。