Importance of Pain Acceptance in Relation to Headache Disability and Pain Interference in Women With Migraine and Overweight/Obesity.
Importance of Pain Acceptance in Relation to Headache Disability and Pain Interference in Women With Migraine and Overweight/Obesity.
复制标题
偏头痛和超重/肥胖女性的头痛残疾和疼痛干扰有关的疼痛接受的重要性。
作者：
Lillis J;Graham Thomas J;Seng EK;Lipton RB;Pavlović JM;Rathier L;Roth J;O'Leary KC;Bond DS
接受疼痛包括愿意体验疼痛，并在疼痛存在时参与有价值的活动。虽然疼痛接受可以限制偏头痛患者的头痛相关残疾和疼痛干扰，但很少有研究解决这个问题。目前的研究评估了偏头痛和超重/肥胖女性的总体疼痛接受度及其两个子成分-疼痛意愿和活动参与度-的较高水平是否与较低的头痛相关损害水平有关。在这项横断面研究中，在妇女健康和偏头痛(WHAM)试验中寻求减肥和头痛缓解的参与者完成了疼痛接受(慢性疼痛接受问卷[CPAQ])、头痛相关残疾(头痛影响测试-6[HIT-6])和疼痛干预(简短疼痛清单[BPI])的基线测量。每天通过智能手机日记评估偏头痛的频率和疼痛强度。使用CPAQ总分和子成分(疼痛意愿和活动投入)得分、头痛频率、疼痛强度和BMI作为线性回归的预测因子，将头痛相关的残疾和疼痛干扰建模为结果。平均而言，参与者(n=126；年龄=38.5±8.2岁；BMI=35.3±6.6 kg/m2)报告偏头痛天数/月为8.4±4.7天，疼痛强度为6.0±1.5(0~10天)。在校正多次比较后(调整后的α=0.008)，疼痛意愿与较低的头痛相关残疾(p<；.001；β=−.233)和疼痛干扰(p<；.001；β=−.261)独立相关。活动投入与头痛相关的残疾(p=.128；β=−.138)和疼痛干扰(p=.042；β=−.154)无关。CPAQ总分与头痛相关残疾(p=.439；β=.066)和疼痛干扰(p=.305；β=.074)无关。在所有分析中，疼痛强度与结果显著相关(P<；.001；β‘S.343−.615)。更高的疼痛意愿，与偏头痛的严重程度和超重程度无关，与偏头痛和超重/肥胖寻求治疗的女性较低的头痛相关残疾和一般疼痛干扰有关。未来的研究需要澄清因果关系的方向，并测试旨在帮助女性提高疼痛意愿或放弃无效的疼痛控制努力的策略是否可以改善患有偏头痛和超重/肥胖的女性的功能结果。
Pain acceptance involves willingness to experience pain and engaging in valued activities while pain is present. Though pain acceptance could limit both headache-related disability and pain interference in individuals with migraine, few studies have addressed this issue. The current study evaluated whether higher levels of total pain acceptance and it’s 2 subcomponents, pain willingness and activity engagement, were associated with lower levels of headache-related impairment in women who had both migraine and overweight/obesity. In this cross-sectional study, participants seeking weight loss and headache relief in the Women’s Health and Migraine (WHAM) trial completed baseline measures of pain acceptance (Chronic Pain Acceptance Questionnaire [CPAQ]), headache-related disability (Headache Impact Test-6 [HIT-6]), and pain interference (Brief Pain Inventory [BPI]). Migraine headache frequency and pain intensity were assessed daily via smartphone diary. Using CPAQ total and subcomponent (pain willingness and activity engagement) scores, headache frequency, pain intensity, and BMI as predictors in linear regression, headache-related disability and pain interference were modeled as outcomes. On average, participants (n=126; age=38.5±8.2 years; BMI=35.3±6.6 kg/m2) reported 8.4±4.7 migraine days/month and pain intensity of 6.0±1.5 on a 0–10 scale on headache days. After correcting for multiple comparisons (adjusted α=.008), pain willingness was independently associated with both lower headache related disability (p<.001; β=−.233) and pain interference (p<.001; β= −.261). Activity engagement was not associated with headache related disability (p=.128; β= −.138) and pain interference (p=.042; β= −.154). CPAQ Total Score was not associated with headache related disability (p=.439; β=.066) and pain interference (p=.305; β=.074). Pain intensity was significantly associated with outcomes in all analyses (p’s <.001; β’s .343−.615). Higher pain willingness, independent of degree of both migraine severity and overweight, is associated with lower headache-related disability and general pain interference in treatment-seeking women with migraine and overweight/obesity. Future studies are needed to clarify direction of causality and test whether strategies designed to help women increase pain willingness, or relinquish ineffective efforts to control pain, can improve functional outcomes in women who have migraine and overweight/obesity.
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