Behavioral Self-management in an Inpatient Headache Treatment Unit: Increasing Adherence and Relationship to Changes in Affective Distress
Article first published online: 25 DEC 2001
Headache: The Journal of Head and Face Pain
Volume 40, Issue 5, pages 377–383, May 2000
How to Cite
Hoodin, F., Brines, B.J., Lake, A.E., Wilson, J. and Saper, J.R. (2000), Behavioral Self-management in an Inpatient Headache Treatment Unit: Increasing Adherence and Relationship to Changes in Affective Distress. Headache: The Journal of Head and Face Pain, 40: 377–383. doi: 10.1046/j.1526-4610.2000.00057.x
- Issue published online: 25 DEC 2001
- Article first published online: 25 DEC 2001
- Accepted for publication December 13, 1999.
- chronic daily headache;
Objective.–To evaluate prospectively the contribution of a psychological self-management program to the amelioration of headache-related distress of patients with intractable migraine treated in a comprehensive, multidisciplinary, inpatient program.
Background.–Previous research has shown the effectiveness of this overall inpatient program but did not examine the relationships between the use of relaxation and other headache-related behavioral factors.
Methods.–Data from 221 admissions to a Commission on Accreditation of Rehabilitation Facilities-accredited, nationally recognized, inpatient treatment unit were analyzed for the current study. On admission and on discharge (average length of stay, 12.9 days), subjects completed a 7-day retrospective, self-report questionnaire assessing health behavior compliance and emotional factors. The intervention consisted of intensive medical therapy in addition to cognitive-behavioral treatment delivered in a group setting.
Results.–Adherence increased significantly for relaxation practice and life-style modifications of diet, exercise, and sleep regulation for headache prevention (P<.00001). Beck Depression Inventory scores decreased significantly (P<.00001), and a greater decrease in depression by the end of the program was reported by subjects who practiced relaxation most compared with those who practiced relaxation least.
Conclusions.–Low baseline adherence rates for health behavior increased significantly during the final week of inpatient treatment. Behavioral self-management variables, not headache reduction, were significantly associated with patients' reduction in affective distress.