Detaillierte Beitrags-Information
| Beitragstitel | Our patients' headache narratives |
|---|---|
| Beitragscode | P17 |
| Autor:innen | |
| Präsentationsform | Freie Mitteilung + Poster |
| Themengebiete |
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| Abstract-Text |
Background Diagnosis of primary headaches is based on the International Classification of Headache Disorders. To differentiate primary headache disorders, physicians have to rely on information obtained in the interview, no additional diagnostic testing is available so far. In addition to its importance in diagnosis, communication is also crucial for management decisions in primary headache disorders (based on headache-associated disability, frequency and intensity of attacks, impact of headaches on daily functions). Despite this crucial role, there are no data on communication of pain and headache-associated disability in headache consultations in Switzerland. Material and Methods This study was part of ComPAIN (Communication of pain in patients with headache), a prospective, cross-sectional study undertaken at the University Hospital of Zurich, representing primarily explorative, qualitative research. We obtained audio and video tapes of headache consultations at our headache ambulatory unit. Patient-clinician conversation was transcribed according to GAT-2, using ELAN Software, therefore allowing for a word-to-word analysis. Results We included a total of 25 patients (18 migraine, 11 TTH). By comparing description of migrainous headaches with tension-type headaches (TTH), we could find a significant difference in the use of "pulsating" (p=0.003) and "unilateral" (p=0.001) as well as in the use of adjectives of consistency (constant, permanent, durable) (p=0.001), variability (various, different, changeable) (p=0.008), and intensity (very, much) (p=0.008). Disease impact was partially discussed in 70.8% of all consultations, but never completely. If disease burden was talked about, it was more often initiated by the patient (50%) than by the clinician (33.3%). Conclusion While migraineurs most often used adjectives of variability and of intensity to describe their pain, TTH patients most often used adjectives of consistency. These word categories also allowed for a reliable differentiation between migrainous and tension-type headaches. A good differentiation could also be made based on the words "unilateral" and "pulsating", which were characteristic of migraine pain. Additionally, we observed that not only was disability never discussed completely in headache consultations, but it was also more often initiated by the patient. This could indicate an unmet need regarding discussion about headache-associated disability in headache consultations. |