Mayo Clinic, Rochester, MN, USA.
J Prim Care Community Health. 2020 Jan-Dec;11:2150132720924874. doi: 10.1177/2150132720924874.
Chronic illness is often comorbid with the psychological state of loneliness. Models of care for patients who experience chronic migraines may often lack an understanding of psychosocial influences of the illness. Addressing the effects of loneliness on the health behaviors of chronic migraine patients may further elucidate gaps in care that exist beyond the biomedical approach to migraine treatment. The primary aim of this study was to assess the relationship between loneliness and behavioral health decisions in chronic migraine patients, specifically patient ability to self-manage, and effectiveness of treatments. We conducted a cross-sectional survey among patients (n = 500) with migraine and assessed for the experience of loneliness by using the University of California, Los Angeles-Revised (UCLA-R) Three-item Loneliness Scale and the extent of migraine-related disability via the Migraine Disability Assessment (MIDAS). Furthermore, we evaluated patients for their ability to self-manage their migraines, and perceived effectiveness of treatment. Nearly half of our population reported at least one measure of loneliness (230/500, 46.0%). Patients experiencing chronic migraine were statistically more likely to report feeling lonely when compared to patients with episodic migraines ( < .001). Patients who report loneliness had lower odds of feeling 'very satisfied" with their ability to self-manage their migraine symptoms (aOR = 0.34, 95% CI 0.14-0.81) and had lower odds of feeling "very satisfied" with their ability to avoid conditions that cause their headache (aOR = 0.39, 95% CI 0.16-0.91). Loneliness has significant effects on the illness experience of patients with chronic migraines, including their ability to self-manage or be satisfied with their current state of care. Psychosocial models of care that address loneliness among patients with chronic migraine may help improve health outcomes and management.
慢性病常常与孤独的心理状态并存。为经历慢性偏头痛的患者提供护理的模式往往缺乏对疾病的社会心理影响的理解。解决孤独对慢性偏头痛患者健康行为的影响可能会进一步阐明超越偏头痛治疗生物医学方法的护理差距。本研究的主要目的是评估孤独感与慢性偏头痛患者行为健康决策之间的关系，特别是患者自我管理能力和治疗效果。我们对患有偏头痛的患者（n=500）进行了横断面调查，使用加利福尼亚大学洛杉矶分校修订版（UCLA-R）三项目孤独量表评估孤独感体验，使用偏头痛残疾评估量表（MIDAS）评估偏头痛相关残疾程度。此外，我们评估了患者自我管理偏头痛的能力以及对治疗的感知效果。近一半的患者报告至少有一种孤独感测量指标（230/500，46.0%）。与发作性偏头痛患者相比，经历慢性偏头痛的患者更有可能报告感到孤独（<0.001）。报告孤独感的患者对自己管理偏头痛症状的能力感到“非常满意”的可能性较低（OR=0.34，95%CI 0.14-0.81），对自己避免引起头痛的情况的能力感到“非常满意”的可能性也较低（OR=0.39，95%CI 0.16-0.91）。孤独感对慢性偏头痛患者的疾病体验有显著影响，包括他们自我管理的能力或对当前护理状况的满意度。针对慢性偏头痛患者孤独感的社会心理护理模式可能有助于改善健康结果和管理。
