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Dione MN, Donelle L, Smye V, Befus D. Self-management Experience of Nurses Living with Migraine: A Qualitative Study. Can J Nurs Res 2024; 56:38-48. [PMID: 37700606 DOI: 10.1177/08445621231199652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/14/2023] Open
Abstract
BACKGROUND Migraine is a neurobiological condition characterized by a constellation of unpredictable symptoms and is the second cause of disability worldwide. Migraine is prevalent among nurses. However, literature exploring nurses' experience of living with migraine is scarce which has important individual and systems implications for health and wellness and patient safety. Self-management is essential in chronic disease management as the patient engages in various strategies to be able to live with their condition. PURPOSE This study explored the experiences of living and working with migraine among female nurses in Ontario, with particular attention to their priorities and strategies for self-management. METHODS Interpretive description methodology was employed to guide this study and informed a thematic analysis approach to examine the self-management experiences of nurses living with migraine. RESULTS Nurses engaged in various self-management strategies including pharmacological and non-pharmacological strategies and highlighted the role of technology in migraine self-management. Participants described experiences of living with migraine as an invisible condition including feelings of not being understood, stigmatization, and the absence of formal support at the workplace. CONCLUSION The implications of these findings support the incorporation of a critical approach to relational engagement that is person-centred including nonjudgemental, strength-based care as a practice approach when caring for persons living with migraines and the need to include experiential learning in educational curriculums as a strategy to reduce stigma against migraines.
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Affiliation(s)
| | - Lorie Donelle
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
- College of Nursing, University of South Carolina, Columbia, South Carolina, USA
| | - Victoria Smye
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
| | - Deanna Befus
- Arthur Labatt Family School of Nursing, Western University, London, Ontario, Canada
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Lin L, Zhu M, Qiu J, Li Q, Zheng J, Fu Y, Lin J. Spatiotemporal distribution of migraine in China: analyses based on baidu index. BMC Public Health 2023; 23:1958. [PMID: 37817123 PMCID: PMC10563210 DOI: 10.1186/s12889-023-16909-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2023] [Accepted: 10/05/2023] [Indexed: 10/12/2023] Open
Abstract
BACKGROUND In recent years, innovative approaches utilizing Internet data have emerged in the field of syndromic surveillance. These novel methods aim to aid in the early prediction of epidemics across various scenarios and diseases. It has been observed that these systems demonstrate remarkable accuracy in monitoring outbreaks even before they become apparent in the general population. Therefore, they serve as valuable complementary tools to augment existing methodologies. In this study, we aimed to investigate the spatiotemporal distribution of migraine in China by leveraging Baidu Index (BI) data. METHODS Migraine-related BI data from January 2014 to December 2022 were leveraged, covering 301 city-level areas from 31 provincial-level regions by using the keyword "migraine ()". Prevalence data from the Global Burden of Disease study (GBD) were attracted to ensure the reliability of utilizing migraine-related BI data for research. Comprehensive analytical methods were then followed to investigate migraine's spatiotemporal distribution. The Seasonal-Trend decomposition procedure based on Loess (STL) was used to identify the temporal distribution. Spatial distribution was explored using the Getis-Ord Gi* statistic, standard deviation ellipse analysis, Moran's Index, and Ordinary Kriging. The top eight migraine-related search terms were analyzed through the Demand Graph feature in the Baidu Index platform to understand the public's concerns related to migraine. RESULTS A strong association was observed between migraine-related BI and the prevalence data of migraine from GBD with a Spearman correlation coefficient of 0.983 (P = 4.96 × 10- 5). The overall trend of migraine-related BI showed a gradual upward trend over the years with a sharp increase from 2017 to 2019. Seasonality was observed and the peak period occurred in spring nationwide. The middle-lower reaches of the Yangtze River were found to be hotspots, while the eastern coastal areas had the highest concentration of migraine-related BI, with a gradual decrease towards the west. The most common search term related to migraine was "How to treat migraine quickly and effectively ()". CONCLUSIONS This study reveals important findings on migraine distribution in China, underscoring the urgent need for effective prevention and management strategies.
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Affiliation(s)
- Liling Lin
- Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Mengyi Zhu
- Zhongshan School of Medicine, Sun Yat-sen University, Guangzhou, China
| | - Junxiong Qiu
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Qiang Li
- Department of Anesthesiology, Sun Yat-sen University Cancer Center, Sun Yat-sen University, Guangzhou, China
| | - Junmeng Zheng
- Department of Cardiovascular Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China
| | - Yanni Fu
- Department of Anesthesiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
| | - Jianwei Lin
- Big Data Laboratory, Joint Shantou International Eye Center of Shantou University and The Chinese University of Hong Kong, Shantou, Guangdong, China.
- Big Data AI Laboratory, Shenshan Medical Center, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Shanwei, Guangdong, China.
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Pirthiraj A, Bhagwan R. The psychosocial impact of migraines on women and alternative therapies for migraine management. Health SA 2023; 28:2249. [PMID: 37795149 PMCID: PMC10546226 DOI: 10.4102/hsag.v28i0.2249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2022] [Accepted: 05/17/2023] [Indexed: 10/06/2023] Open
Abstract
Background Migraines are one of the leading causes of disability globally and in South Africa. There is a paucity of local empirical literature regarding the psychosocial impact of migraines on women. Although there are a variety of treatment approaches, many women prefer alternative and holistic treatment for their migraines. Aim The aim of this study was to explore the psychosocial impact of migraines on women and their use of complementary and alternative therapies for migraine pain management. Setting The study was conducted in the eThekwini region of KwaZulu-Natal, South Africa. Methods The study adopted a qualitative descriptive design. Purposive sampling was used to recruit participants for the study. Data were collected through 12 semi-structured interviews and subsequently analysed using thematic analysis. Results Theme 1 related to the psychological and cognitive effects experienced by the participants. Theme 2 focused on the effects migraines had on personal, family and social relationships. Theme 3 discussed the self-management of migraines. Conclusion The pertinent psychological effects of migraines were depression, anxiety, feelings of hopelessness and withdrawal, fear-avoidance behaviour, lifestyle changes, and acceptance of migraines. The participants experienced a lack of understanding about their migraine severity from co-workers, family and social networks. The alternative therapies that were sought to alleviate migraine symptoms included chiropractic, massage, meditation, reflexology, yoga, cupping and acupuncture. Contribution The awareness of the effectiveness of complementary and alternative therapies for women may be beneficial for healthcare providers seeking a multidisciplinary approach to migraine management.
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Affiliation(s)
- Ashalya Pirthiraj
- Department of Chiropractic, Faculty of Health Sciences, Durban University of Technology, Durban, South Africa
| | - Raisuyah Bhagwan
- Department of Community Health Studies, Faculty of Health Science, Durban University of Technology, Durban, South Africa
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Urtecho M, Wagner B, Wang Z, VanderPluym JH, Halker Singh RB, Noyes J, Butler ME, Murad MH. A qualitative evidence synthesis of patient perspectives on migraine treatment features and outcomes. Headache 2023; 63:185-201. [PMID: 36602191 DOI: 10.1111/head.14430] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2022] [Revised: 09/24/2022] [Accepted: 09/26/2022] [Indexed: 01/06/2023]
Abstract
OBJECTIVES We aimed to identify migraine treatment features preferred by patients and treatment outcomes most valued by patients. BACKGROUND The values and preferences of people living with migraine are critical for both the choice of acute therapy and management approach of migraine. METHODS We conducted a qualitative evidence synthesis. Two reviewers independently selected studies, appraised methodological quality, and undertook a framework synthesis. We developed summary of findings tables following the approach of Grading of Recommendations, Assessment, Development and Evaluations Confidence in the Evidence from Reviews of Qualitative Research to assess confidence in the findings. RESULTS Of 1691 candidate references, we included 19 studies (21 publications) involving 459 patients. The studies mostly recruited White women from North America (11 studies) and Europe (8 studies). We identified eight themes encompassing features preferred by patients in a migraine treatment process. Themes described a treatment process that included shared decision-making, a tailored approach, trust in health-care professionals, sharing of knowledge and diversity of treatment options, a holistic approach that does not just address the headache, ease of communication especially for complex treatments, a non-undermining approach, and reciprocity with mutual respect between patient and provider. In terms of the treatment itself, seven themes emerged including patients' preferences for nonpharmacologic treatment, high effectiveness, rapidity of action, long-lasting effect, lower cost and more accessibility, self-management/self-delivery option that increases autonomy, and a mixed preference for abortive versus prophylactic treatments. The treatment outcomes that have high value to patients included maintaining or improving function; avoiding side effects, potential for addiction to medications, and pain reoccurrence; and avoiding non-headache symptoms such as nausea, vomiting, and sensitivity to light or sounds. CONCLUSION Patient values and preferences were individually constructed, varied widely, and could be at odds with conventional medical perspectives and evidence of treatment effects. Considering the availability of numerous treatments for acute migraine, it is necessary that decision-making incorporates patient values and preferences identified in qualitative research. The findings of this qualitative synthesis can be used to facilitate an individually tailored approach, strengthen the patient-health-care system relationship, and guide choices and decisions in the context of a clinical encounter or a clinical practice guideline.
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Affiliation(s)
- Meritxell Urtecho
- Mayo Clinic Evidence-Based Practice Center, Rochester, Minnesota, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
| | - Brittin Wagner
- Minnesota Evidence-Based Practice Center, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Zhen Wang
- Mayo Clinic Evidence-Based Practice Center, Rochester, Minnesota, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA.,Division of Health Care Delivery Research, Mayo Clinic, Rochester, Minnesota, USA
| | - Juliana H VanderPluym
- Mayo Clinic Evidence-Based Practice Center, Rochester, Minnesota, USA.,Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Rashmi B Halker Singh
- Mayo Clinic Evidence-Based Practice Center, Rochester, Minnesota, USA.,Department of Neurology, Mayo Clinic, Scottsdale, Arizona, USA
| | - Jane Noyes
- School of Medical and Health Sciences, Bangor University, Bangor, UK
| | - Mary E Butler
- Minnesota Evidence-Based Practice Center, University of Minnesota School of Public Health, Minneapolis, Minnesota, USA
| | - Mohammad Hassan Murad
- Mayo Clinic Evidence-Based Practice Center, Rochester, Minnesota, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, Minnesota, USA
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Rist PM, Bernstein C, Kowalski M, Osypiuk K, Connor JP, Vining R, Long CR, Macklin EA, Wayne PM. Multimodal chiropractic care for migraine: A pilot randomized controlled trial. Cephalalgia 2021; 41:318-328. [PMID: 33050719 PMCID: PMC9670157 DOI: 10.1177/0333102420963844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
BACKGROUND Spinal manipulation may reduce migraine frequency, but effects of multimodal chiropractic care on migraine frequency have not been evaluated. METHODS We conducted a pilot randomized controlled trial comparing multimodal chiropractic care + enhanced usual care (MCC+) versus enhanced usual care alone (EUC) among adult women with episodic migraine. EUC was comprised of usual medical care and migraine education literature. MCC+ participants received 10 sessions of chiropractic care over 14 weeks. Primary aims evaluated feasibility of recruitment, retention, protocol adherence, and safety. Change in migraine days was a secondary aim. RESULTS Of 422 patients screened, 61 were randomized over 20 months. Fifty-seven (93%) completed daily migraine logs during the intervention, 51 (84%) completed final follow-up, and 45 (74%) completed all assessments. Twenty-four of 29 MCC+ participants (83%) attended > 75% of the chiropractic sessions. Ninety-eight non-serious adverse events were reported by 26 participants (43%) with 39 events among 11 EUC participants and 59 events among 15 MCC+ participants. MCC+ participants experienced greater reductions in migraine days (-2.9 days for MCC+ vs. -1.0 days for EUC, difference = -1.9; 95% confidence interval: -3.5, -0.4). CONCLUSIONS Pre-specified feasibility criteria were not met, but deficits were remediable. Preliminary data support a definitive trial of MCC+ for migraine. TRIAL REGISTRATION This study is registered at Clinicaltrials.gov (NCT03177616).
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Affiliation(s)
- Pamela M. Rist
- Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA
| | - Carolyn Bernstein
- John Graham Headache Center, Department of Neurology, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA
- Osher Clinical Center, Brigham and Women’s Hospital, Boston, MA
| | | | - Kamila Osypiuk
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA
| | - Julie P. Connor
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA
| | | | | | - Eric A. Macklin
- Biostatistics Center, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, United States of America
| | - Peter M. Wayne
- Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women’s Hospital, Boston, MA
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Connor JP, Bernstein C, Kilgore K, Rist PM, Osypiuk K, Kowalski M, Wayne PM. Perceptions of Chiropractic Care Among Women With Migraine: A Qualitative Substudy Using a Grounded-Theory Framework. J Manipulative Physiol Ther 2021; 44:154-163. [PMID: 33431279 DOI: 10.1016/j.jmpt.2020.07.001] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Revised: 06/18/2020] [Accepted: 07/01/2020] [Indexed: 02/07/2023]
Abstract
OBJECTIVE The purpose of this study was to characterize expectations, attitudes, and experiences of individuals with migraine who were randomly assigned to receive chiropractic care delivered within a randomized controlled trial in a hospital-based integrative care center. METHODS This qualitative substudy was conducted as a part of a 2-arm pilot pragmatic randomized controlled trial investigating a multimodal model of chiropractic care for women with episodic migraine (4-13 migraines per month). Women were randomly assigned to chiropractic care (10 sessions over 14 weeks) plus enhanced usual care vs enhanced usual care alone. Semistructured interviews were conducted at baseline and 14-week follow-up with 15 randomly selected participants from the 29 participants randomized to the chiropractic group. Qualitative analysis was performed by 2 independent reviewers using a constant comparative method of analysis for generating grounded theory. RESULTS Integrating baseline and follow-up interviews, 3 themes emerged: over the course of treatment with chiropractic care, participants became more aware of the role of musculoskeletal tension, pain, and posture in triggering migraine; participants revised their prior conceptions of chiropractic care beyond spinal manipulation; and participants viewed the chiropractor-patient relationship as an essential and valuable component to effectively managing their migraines. CONCLUSION In this qualitative study, women with episodic migraine after receiving comprehensive chiropractic care described chiropractic as a multimodal intervention where they learned about musculoskeletal contributions to migraine, discovered new ways to affect their symptoms, and developed a collaborative patient-practitioner relationship. The results of this study provide insights into perceptions of chiropractic care among women with migraine and suggestions for future trials.
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Affiliation(s)
- Julie P Connor
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts.
| | - Carolyn Bernstein
- Osher Clinical Center, Brigham and Women's Hospital, Chestnut Hill, Massachusetts; John Graham Headache Center, Department of Neurology, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
| | - Karen Kilgore
- School of Special Education, School Psychology & Early Childhood Studies, University of Florida, Gainesville, Florida
| | - Pamela M Rist
- Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts; Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, Massachusetts
| | - Kamila Osypiuk
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
| | - Matthew Kowalski
- Osher Clinical Center, Brigham and Women's Hospital, Chestnut Hill, Massachusetts
| | - Peter M Wayne
- Osher Center for Integrative Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts; Division of Preventive Medicine, Department of Medicine, Harvard Medical School and Brigham and Women's Hospital, Boston, Massachusetts
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