Smith Allison M, Schefter Zoë J, Rogan Hannah
Division of Pain Medicine, Department of Anesthesiology, Perioperative & Pain Medicine, Boston Children's Hospital, Waltham, MA 02453, USA.
Division of Psychology, Department of Psychiatry, Harvard Medical School, Boston, MA 02115, USA.
Children (Basel). 2022 Dec 13;9(12):1956. doi: 10.3390/children9121956.
Primary headache disorders are common yet underestimated in youth, resulting in functional disability, decreased quality of life, and caregiver burden. Despite the ubiquity of options, adherence remains challenging for families. One potential factor impacting willingness to engage in recommended treatments is openness. This study explored openness to multidisciplinary headache interventions and the relationships with demographic, pain-related, and psychological variables, among youth and their caregivers. Participants ( = 1087) were youth/caregiver dyads presenting for initial headache evaluation. They completed assessments of openness to headache treatments, medical information, functional disability, and pain-related distress. Overall openness was moderately high for youth and caregivers, and highly correlated between them (r = 0.70). Relationships between youth/caregiver openness to specific interventions were moderate-high (r = 0.42-0.73). These were stronger for interventional techniques but weaker for lifestyle changes. In hierarchical regression models predicting youth and caregiver openness, we found that counterpart openness accounted for the largest portion of variance in their own openness (31-32%), beyond demographic (3%), pain-related (10%), and psychological variables (2-3%). Our findings highlight the importance of involving caregivers in pediatric headache management, given their influence on youth openness and potential involvement in adherence. Awareness of youth/caregiver openness may guide clinicians providing recommendations.
原发性头痛疾病在青少年中很常见,但却被低估了,这导致了功能残疾、生活质量下降以及照顾者负担加重。尽管有多种选择,但对家庭来说,坚持治疗仍然具有挑战性。影响参与推荐治疗意愿的一个潜在因素是开放性。本研究探讨了青少年及其照顾者对多学科头痛干预措施的开放性,以及与人口统计学、疼痛相关和心理变量之间的关系。参与者(n = 1087)是前来进行初次头痛评估的青少年/照顾者二元组。他们完成了对头痛治疗开放性、医疗信息、功能残疾和疼痛相关困扰的评估。青少年和照顾者的总体开放性中等偏高,且两者之间高度相关(r = 0.70)。青少年/照顾者对特定干预措施的开放性之间的关系为中等偏高(r = 0.42 - 0.73)。这些关系在干预技术方面更强,但在生活方式改变方面较弱。在预测青少年和照顾者开放性的分层回归模型中,我们发现对方的开放性在其自身开放性的方差中占最大比例(31 - 32%),超过了人口统计学因素(3%)、疼痛相关因素(10%)和心理变量(2 - 3%)。我们的研究结果强调了让照顾者参与儿童头痛管理的重要性,因为他们对青少年的开放性有影响,并且可能参与到治疗的坚持中。了解青少年/照顾者的开放性可能会指导临床医生提供建议。