Measuring the Functional Status and Well-Being of Patients with Migraine Headache

SYNOPSIS
Objective: Compare adult migraineurs' health related quality of life to adults in the general U.S. population reporting no chronic conditions, and to samples of patients with other chronic conditions. Methods: Subjects (n=845) were surveyed 2–6 months after participation in a placebo-controlled clinical trial and asked to complete a questionnaire including the SF-36 Health Survey, a migraine severity measurement scale and demographics. Results were adjusted for severity of illness and comorbidities. Scores were compared with responses to the same survey by the U.S. sample and by patients with other chronic conditions. Results: Response rate was 67%. After adjustment for comorbid conditions, SF-36 scale scores were significantly (P 0.001 ) lower in migraineurs, relative to age and sex-adjusted norms for the U.S. sample with no chronic conditions. Some health dimensions were more affected by migraine than other chronic conditions, while other dimensions were less affected by migraine. Measures of bodily pain, role disability due to physical health and social functioning discriminated best between migraineurs, the U.S. sample, and patients with other chronic conditions. Patients reporting moderate, severe and very severe migraines scored significantly (P £ 0.001 ) lower on five of the eight SF-36 scales than the U.S. sample. Conclusions: Migraine has a unique, significant quality of life burden.     

Loss of Productivity and Quality of Life in Migraine Sufferers Among French Workers: Results From the GAZEL Cohort

To assess the burden of migraine, we compared the productivity and the perceived health of 991 migraine sufferers (IHS criteria), 1004 other-headache sufferers, and 1757 nonheadache sufferers randomly chosen among volunteers from employees of the French national gas and electricity company. The extent of absenteeism was collected independently from the study subjects during a 4-year period. Performance at work was self-assessed at the end of the followup. The study subjects also completed the Short-Form 36 Health Survey Questionnaire (SF36) and the Spielberger anxiety scale. The number of workdays lost due to migraine was not statistically different between the migraine and control groups, after adjustment for age, sex, and number of health impairments other than headaches. Performance was found to be greatly reduced in migraineurs. The quality of life was poorer and the anxiety level was higher in the migraine group than in the nonheadache group. There was no difference between migraineurs and other-headache sufferers for any variable. The lack of difference in absenteeism between migraineurs and nonheadache subjects calls into question prior research based on self-report. Moreover, it also calls into question the economic impact of migraine due to its indirect costs found in previous studies without e control group. We found that the burden of migraine may be considered mainly in terms of reduced quality of life.     

Kinesiophobia and Its Association With Health-Related Quality of Life Across Injury Locations

Objective

To compare baseline kinesiophobia levels and their association with health-related quality of life across injury locations.

椎体成形术对骨转移癌痛患者生活质量的影响

目的探讨椎体成形术对晚期骨转移癌患者生活质量的影响。方法收集2011年1月~2012年12月,采用椎体成形术治疗脊柱椎体骨转移癌的患者12例,术前、术后1周、术后1个月采用健康调查简表(SF-36)、视觉模拟评分(VAS)对患者生活质量、疼痛改善状况等进行对比分析。结果生理职能(RP)、情感职能(RE)无变化;生理功能(PF)、活力(VT)、社会功能(SF)、精神健康(MH)呈上升趋势;躯体疼痛(BP)在术后1周与术前相比呈上升趋势,术后1个月与术后1周相比呈轻微下降趋势;总体健康(GH)在术前、术后1周和术后1个月相比呈下降趋势。术后1周和术后1个月相对于术前VAS评分显著下降(P<0.001)。术后1周相对于术前疼痛改善率为61.46%,术后1个月相对于术前疼痛改善率为57.96%。结论椎体成形术可以短期内有效改善椎体转移癌患者的生活质量,减轻疼痛。     

脑卒中病人生活质量的多中心研究

目的：了解脑卒中病人的生活质量(QOL)及其影响因素。方法：采用多中心研究方法，应用健康测量量表SF-36和自行编制的“患者一般状况量表”，对西安市、兴平市和户县共11所不同等级医院的神经内外科和老年病科共146例脑卒中病人进行调查，用多元逐步回归方法分析影响生活质量的因素。结果：脑卒中病人的生活质量明显低于正常人群，生活质量与吸烟、偏瘫、家人对病人的关心和健康变化状况有关。结论：加强脑卒中及其有关疾病尤其是偏瘫的治疗和康复护理，改善病人的躯体功能，劝其戒烟，鼓励家属给予更多的关心和支持，是促进脑卒中病人早日康复的重要保证。     

Quality of life in migraine and chronic daily headache patients

Primary chronic headache can affect a patient's health-related quality of life (HQL). The Medical Outcomes Study Short Form (SF-36) questionnaire has been used to address this issue. We compare the impact of headache on the HQL of patients with migraine and chronic daily headache (CDH) using the SF-36 instrument. We analyzed a group of 115 consecutive patients; 62 migraine patients and 53 CDH patients completed the questionnaire. Patterns of disability were similar between the two groups, but CDH was marked by a lower level of health scales. Patients with CDH had a significantly worse pain score in physical functioning, role functioning (physical), bodily pain, general health perceptions, and mental health than patients with migraine headache. Our results in the migraine group were similar to findings in other publications, with the lowest scores in role functioning (physical) and bodily pain. There is no previous experience in CDH patients, but the present data suggest that the SF-36 questionnaire is valuable in determining the differences in functional status among headache types. These data suggest that the SF-36 is a reliable and valid measure of the HQL of patients with CDH, and may indeed prove to be valuable in studying the efficacy of therapeutic agents for this type of headache.     

银屑病患者生活质量及其影响因素的研究

目的对银屑病患者的生活质量进行评定并探讨其影响因素。方法应用皮肤病专用生活质量量表Skindex-29和非特异性生活质量量表(the short form-36health survey,SF-36)对2011年3月至2012年3月在中国医学科学院皮肤病医院就诊或住院的104例银屑病患者(观察组)和108例湿疹患者(对照组)的生活质量进行分析和比较。结果观察组Skindex-29评分高于对照组,差异有统计学意义(P0.05);SF-36评分观察组低于对照组,在活力、情感职能、社会功能3个方面差异有统计学意义(P0.05);逐步回归分析结果显示,病程、受教育程度、皮肤损伤面积及复发情况进入回归方程有统计学意义(P0.05),且与Skindex-29结果呈正相关,与SF-36结果呈负相关。结论银屑病对患者的生活质量造成了负面影响,应尽早采取干预;病程越长,皮肤损伤面积越大,复发次数越多的患者Skindex-29越高、SF-36越低,即生活质量越差。     

SF-36量表应用于老年一般人群的信度和效度研究

目的评价SF-36量表在老年一般人群的信度和效度。方法采用SF-36生存质量量表,由经过统一培训的调查员对济南市60岁及以上的老年人1386人进行面对面访谈,并计算8项内容的评分。信度包括重测信度、分半信度和内部信度;效度包括判别效度和结构效度。采用相关分析、信度分析和因子分析方法对SF-36量表的信度和效度进行评价。结果各项重测信度的组内相关系数(ICCs)均>0.5;各项分半信度系数均>0.7;各项内部信度的Cronbach'a系数均>0.70。在判别效度的评价中,实际结果与理论推断和以往研究结果相一致,表明量表的判别效度较好;在结构效度的评价中,因子分析所产生的两个公共因子可解释总变异的66.25%,并在相应项目上有较强的因子负荷,表明量表的结构效度较好。结论SF-36量表具有较好的信度和效度,适于评价老年一般人群的生存质量。     

情志护理对脑卒中后抑郁患者生存质量的影响

且的观察情志护理对脑卒中后抑郁患者生存质量的如响。方法对64例卒中后抑郁患者在脑卒中常规护理的基础上,采用情志护理方案干预1个月。在干预前和干预后采用SF-36生存质量量表对患者的生存质量进行评定和比较。结果干预后本组SF-36生存质量量表得分在生理功能、生理职能、情感职能、活力、社会功能、躯体疼痛、精神健康、总体健康8个维度较干预前有明显的提高（P〈0．01）。结论情志护理有利于改善卒中后抑郁患者的生存质量,对脑卒中后抑郁患者的生存质量具有长远的影响。     

Validation of a New Quality of Life Questionnaire for Acute Migraine Headache

A brief migraine-specific quality of life questionnaire was developed to assess the quality of life decrement associated with an acute migraine attack in the 24-hour period following headache onset, The migraine quality of life questionnaire has 15 questions across five domains (work functioning, social functioning, energy, concerns, and symptoms). A prospective, observational study was conducted to evaluate the characteristics of internal consistency, construct and discriminant validity, and responsiveness of the migraine quality of life questionnaire. One hundred thirty-eight subjects with migraine were recruited. One hundred seven subjects completed a baseline and a 24-hour postmigraine quality of life questionnaire, along with a migraine diary for recording headache severity, activity limitation, associated symptoms, duration of headache, and use of migraine medication. All five migraine quality of life questionnaire domains showed good internal consistency (Cronbach's alpha, 0.74–0.95). The strongest correlations were seen between activity limitation and associated symptoms and the migraine quality of life questionnaire work, social, and energy domains. Significant differences in mean questionnaire scores between subjects were found with frequency of medication use, global change in symptoms, headache duration, and severity. All five domains showed significant responses within subjects from a migraine-free period to an acute migraine period ( P <0.0001). In summary, the migraine quality of life questionnaire showed good internal consistency, construct and discriminant validity, and responsiveness to acute migraine attacks.     

Health Conditions: Effect on Function,Health-Related Quality of Life,and Life Satisfaction After Traumatic Spinal Cord Injury. A Prospective Observational Registry Cohort Study

Objective

To analyze relations among injury, demographic, and environmental factors on function, health-related quality of life (HRQoL), and life satisfaction in individuals with traumatic spinal cord injury (SCI).

Health-related quality of life in patients with cluster headache during active periods

Cluster headache is characterized by excruciatingly painful headaches which occur one or several times during the day. Little is known about the functional consequences of this severe headache form. We assessed health-related quality of life in 56 consecutive patients, 34 of whom were episodic cluster headache patients during an active period, and 22 had chronic cluster headache. All patients completed the Short Form-36 (SF-36). We found lower scores in the studied patients than in those reported in the general population for all SF-36 domains. For most scales the difference was significant (P < 0.0001, Student's t-test, Bonferroni correction). Our findings suggest that cluster headache has marked functional consequences even when appropriate treatments are used.     

Improvement in quality of life and activity limitations in migraine patients after prophylaxis. A prospective longitudinal multicentre study

Improved health-related quality of life (HRQOL) and reduced activity limitations are prime objectives of migraine therapy, but no data on the effect of preventive treatments on these outcomes are available. We monitored changes in HRQOL using the Short Form 36 (SF-36) and headache-related activity limitations using the Migraine Disability Assessment Score (MIDAS) in 141 consecutive migraine without aura patients on prophylaxis. A total of 102 patients completed the 3-month study. Mean (SD) number of headache days/month dropped from 8.0 (3.7) to 5.0 (2.3) (P < 0.001). Mean monthly consumption of acute drugs reduced from 7.4 (3.5) to 4.4 (3.1) (P < 0.001). MIDAS total score reduced (improved) significantly. All SF-36 scale scores increased (improved), most significantly. This first study to assess prospectively the impact of prophylaxis on HRQOL and daily activities in a large series indicates that migraine prophylaxis has the potential to reduce the global burden of migraine on individuals and society.     

Quality of Life in Pediatric Patients with Cystic Fibrosis

In order to assess quality of life, we administered the Child Health Questionnaire (CHQ) to 43 pediatric patients diagnosed with cystic fibrosis (CF). Statistical analyses demonstrated that girls with CF perceive themselves to have better general health and report greater optimism regarding their future health than do boys with CF. Findings also revealed that age negatively correlated with general health perception, such that patients report worse general health as they become older. In addition, we administered the parent version of the CHQ to one of each patient's parents for the purpose of comparing their perceptions to those of their children. Results indicated that in each of the domains assessed parents perceive their children to experience greater impairment than that reported by patients. Finally, comparisons of parents' perceptions of the quality of life (QOL) of their children with CF versus parents' perceptions of the QOL of their children who have other chronic illness revealed variable patterns of impairment.     

Impact of preventive therapy with nadolol and topiramate on the quality of life of migraine patients

Preventive therapy is aimed at reducing migraine frequency, but should also improve the much deteriorated quality of life of the migraneur. We aimed to evaluate the impact of preventive therapy with two widely employed drugs (topiramate and nadolol) on the quality of life of migraine patients. A population of consecutive migraineurs aged > or = 16 years, with frequent migraines, was selected prospectively for evaluation at baseline and after 16 weeks of therapy with nadolol or topiramate (40 mg and 100 mg daily, respectively) by generic and specific quality of life questionnaires (SF-36 and MSQOL) and by an anxiety and depression scale (HADS). Preventive therapy resulted in a statistically significant improvement in physical domains of the SF-36, whereas mental domains remained almost unchanged. Despite this improvement, all domains remained below the population norms. The HADS revealed a moderate depressive state at baseline that did not change with therapy. The MSQOL global score also revealed statistically significant improvement. Both drugs were similarly effective, although topiramate was superior on the role physical domain compared with nadolol. Preventive therapy with nadolol and topiramate significantly improves the quality of life of migraineurs, although additional efforts are needed to place them in a nearer-to-normal situation compared with the general population.     

Quality of Life and Adaptation in People With Spinal Cord Injury: Response Shift Effects From 1 to 5 Years Postinjury

Objective

To investigate response shift effects in spinal cord injury (SCI) over 5 years postinjury.