Management of Chronic Daily Headache and Psychiatric Co-Morbidities by Lifestyle Modification: Participatory Action Research Combining New Communication Media

Abstract

BackgroundLifestyle modification has a significant role in chronic daily headache (CDH) management. Participatory action research (PAR) can play an important role in managing chronic medical conditions. However, it has been scarcely used in CDH management.ObjectivesThis study aimed to empower patients with CDH to modify their lifestyle in order to reduce both their headache and related psychiatric co-morbidities in a multidisciplinary headache clinic at Baqiyatallah hospital, Tehran, IR Iran.MethodsIn the PAR plan, 37 patients (27 females) diagnosed with CDH were selected using purposeful sampling. Along with face-to-face group sessions, all available communication means such as phone calls, emails, short message system (SMS), and social media (Telegram) were used to facilitate the process. Questionnaires of health promotion lifestyle profile (HPLPІІ), visual analog scale (VAS), and depression-anxiety-stress scale (DASS21) were used to collect data. The data were analyzed using SPSS software.ResultsMean age of the patients was 38.33 (± 9.7) years. Both “general pain” and “the worst imaginable pain” reduced (mean of reduction: 2.56 ± 2.7 and 2.3 ± 2.9, respectively, P < 0.001). > 50% of pain reduction occurred in “the worst imaginable pain" category (-1.45 ± 2.02, P < 0.001) and mean VAS score reduced to 5.20 (± 2.3) compared to the start of the study (7.50 ± 1.9, P < 0.001). Mean DASS-21 score also reduced significantly for depression (P < 0.016), anxiety (P < 0.026), and stress (P < 0.008). HPLPІІ score significantly improved (118.17 ± 14.8 vs. 160.83 ± 16.4, P < 0.001) and the highest increase was seen in the subscale of "stress management" (17.73 ± 2.8 vs. 25.53 ± 3.9, P < 0.001).ConclusionsThe empowering PAR plan combined with new communication tools helped the CDH patients better handle their lifestyle, reduce their headache, and lower their symptoms. Further studies with better use of currently available communication tools and social media are recommended for action research to be more applicable.

The Utility of Participatory Action Research in the Nursing Field: A Scoping Review

“…Goeman et al, 2016;D. P. Goeman et al, 2017;Haesebaert et al, 2018;Liang et al, 2019;O'Reilly-de Brún et al, 2018), while three were quantitative (Faizi et al, 2017;Hestevik et al, 2019;Vafaei et al, 2018). One article was a case study (Fletcher et al, 2015), one was explorative/descriptive (Salzmann-Erikson, 2017), and one used mixed methods (Carroll, 2017).…”

“…P. Goeman et al, 2017); one used intervention co-creation and PAR approaches (D. Goeman et al, 2016); and two used semi-structured interview guides to facilitate discussion of adult and youth focus groups (Atkins et al, 2018;Fletcher et al, 2015). One article applied audio-recording interventions to the meetings and questionnaires (Haesebaert et al, 2018), one used discussion group intervention (support groups; De-La-Cueva-Ariza et al, 2018), one involved a pre-posttest design intervention (Hestevik et al, 2019), one adopted interview intervention with the participant (Vafaei et al, 2018), one employed peer group discussions (Liang et al, 2019), and one used face-to-face group sessions interventions (Faizi et al, 2017). One article applied a comparative case study intervention (O'Reilly-de Brún et al, 2018), one used multilevel discussion group meetings and documentary analysis (De-La-Cueva-Ariza et al, 2018), and one involved participatory observation, interviews, and references to document interventions (Memarzadeh et al, 2017).…”

“…Of the 20 reviewed articles, six used PAR approaches to produce positive change in nursing practice documentation and also appeared suitable for effective outcome modification. In six studies, significant improvement was achievable by engaging staff and particularly leaders, in order to maintain focus and ensure sustainability (De-La-Cueva-Ariza et al, 2018;Faizi et al, 2017, Fletcher et al, 2015Hestevik et al, 2019;Liang et al, 2019;O'Reilly-de Brún et al, 2018). Three articles reported combining PAR with other appropriate practices to ensure better documentation, including nurse participation, compliance with documentation standards, managerial accountability, leadership style enhancement, and sustainable monitoring and control (Carroll, 2017;Salzmann-Erikson, 2017;Vafaei et al, 2018).…”

Role of educational programs in management of patients with medication-overuse headache

“…Это позволило уменьшить интенсивность головной боли, что согласуется с данными F. Faizi и соавт. [15]. Они изучали влияние обучения коррекции образа жизни на уменьшение головной боли.…”

“…Например, средний балл по ВАШ снизился до 5,20±2,3 по сравнению с началом исследования (7,50±1,9; р<0,001). Авторы рекомендуют проведение дальнейших ис- следований с более эффективным использованием имеющихся в настоящее время средств коммуникации и социальных сетей, чтобы практические исследования были более применимыми [15].…”