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- Title
Learning the full impact of migraine through patient voices: A qualitative study.
- Authors
Estave, Paige M.; Beeghly, Summerlyn; Anderson, Reid; Margol, Caitlyn; Shakir, Mariam; George, Geena; Berger, Anissa; O'Connell, Nathaniel; Burch, Rebecca; Haas, Niina; Powers, Scott W.; Seng, Elizabeth; Buse, Dawn C.; Lipton, Richard B.; Wells, Rebecca Erwin
- Abstract
Objective: To better characterize the ways that migraine affects multiple domains of life. Background: Further understanding of migraine burden is needed. Methods: Adults with migraine randomized to mindfulness‐based stress reduction or headache education arms (n = 81) in two separate randomized clinical trials participated in semistructured in‐person qualitative interviews conducted after the interventions. Interviews queried participants on migraine impact on life and were audio‐recorded, transcribed, and summarized into a framework matrix. A master codebook was created until meaning saturation was reached and magnitude coding established code frequency. Themes and subthemes were identified using a constructivist grounded theory approach. Results: Despite most participants being treated with acute and/or prophylactic medications, 90% (73/81) reported migraine had a negative impact on overall life, with 68% (55/81) endorsing specific domains of life impacted and 52% (42/81) describing impact on emotional health. Six main themes of migraine impact emerged: (1) global negative impact on overall life; (2) impact on emotional health; (3) impact on cognitive function; (4) impact on specific domains of life (work/career, family, social); (5) fear and avoidance (pain catastrophizing and anticipatory anxiety); and (6) internalized and externalized stigma. Participants reported how migraine (a) controls life, (b) makes life difficult, and (c) causes disability during attacks, with participants (d) experiencing a lack of control and/or (e) attempting to push through despite migraine. Emotional health was affected through (a) isolation, (b) anxiety, (c) frustration/anger, (d) guilt, (e) mood changes/irritability, and (f) depression/hopelessness. Cognitive function was affected through concentration and communication difficulties. Conclusions: Migraine has a global negative impact on overall life, cognitive and emotional health, work, family, and social life. Migraine contributes to isolation, frustration, guilt, fear, avoidance behavior, and stigma. A greater understanding of the deep burden of this chronic neurological disease is needed to effectively target and treat what is most important to those living with migraine.
- Subjects
MINDFULNESS; FRUSTRATION; MIGRAINE; RESEARCH methodology; GROUNDED theory; INTERVIEWING; HEALTH outcome assessment; MENTAL health; COGNITION; FEAR; SOCIAL stigma; GUILT (Psychology); PATIENTS' attitudes; RANDOMIZED controlled trials; QUALITATIVE research; AVOIDANCE (Psychology); STRESS management; QUALITY of life; DESCRIPTIVE statistics; DESPAIR; MENTAL depression; HEADACHE; STATISTICAL sampling; THEMATIC analysis; ANXIETY; ANGER
- Publication
Headache: The Journal of Head & Face Pain, 2021, Vol 61, Issue 7, p1004
- ISSN
0017-8748
- Publication type
Article
- DOI
10.1111/head.14151