Relationship between Self-Efficacy and Headache Impact, Anxiety, and Physical Activity Levels in Patients with Chronic Tension-Type Headache: An Observational Study

Abstract

Background. Chronic tension-type headache is the primary headache with the highest prevalence. The present study is aimed at analyzing the associations between patient self-efficacy and headache impact with pain characteristics, kinesiophobia, anxiety sensitivity, and physical activity levels in subjects with chronic tension-type headache. Materials and Methods. An observational descriptive study was carried out. A total sample of 42 participants was recruited at university environment with diagnosis of tension-type headache. Headache characteristics (frequency, intensity, and duration), physical activity levels, pain related-self-efficacy, kinesiophobia, anxiety sensitivity, and headache impact were measured. Results. The HIT-6 ( <a:math xmlns:a="http://www.w3.org/1998/Math/MathML" id="M1"> <a:mn>61.05</a:mn> <a:mo>±</a:mo> <a:mn>6.38</a:mn> </a:math> ) score showed significant moderate positive correlations with the ASI-3 score ( <c:math xmlns:c="http://www.w3.org/1998/Math/MathML" id="M2"> <c:mn>17.64</c:mn> <c:mo>±</c:mo> <c:mn>16.22</c:mn> </c:math> ; <e:math xmlns:e="http://www.w3.org/1998/Math/MathML" id="M3"> <e:mi>r</e:mi> <e:mo>=</e:mo> <e:mn>0.47</e:mn> </e:math> ) and moderate negative correlations with the self-efficacy in the domains of pain management ( <g:math xmlns:g="http://www.w3.org/1998/Math/MathML" id="M4"> <g:mn>31.9</g:mn> <g:mo>±</g:mo> <g:mn>10.28</g:mn> </g:math> ; <i:math xmlns:i="http://www.w3.org/1998/Math/MathML" id="M5"> <i:mi>r</i:mi> <i:mo>=</i:mo> <i:mo>−</i:mo> <i:mn>0.43</i:mn> </i:math> ) and coping with symptoms ( <k:math xmlns:k="http://www.w3.org/1998/Math/MathML" id="M6"> <k:mn>53.81</k:mn> <k:mo>±</k:mo> <k:mn>14.19</k:mn> </k:math> ; <m:math xmlns:m="http://www.w3.org/1998/Math/MathML" id="M7"> <m:mi>r</m:mi> <m:mo>=</m:mo> <m:mo>−</m:mo> <m:mn>0.47</m:mn> </m:math> ). ASI-3 score had a negative large correlation with self-efficacy in the domains of pain management ( <o:math xmlns:o="http://www.w3.org/1998/Math/MathML" id="M8"> <o:mi>r</o:mi> <o:mo>=</o:mo> <o:mo>−</o:mo> <o:mn>0.59</o:mn> </o:math> ), physical function ( <q:math xmlns:q="http://www.w3.org/1998/Math/MathML" id="M9"> <q:mn>53.36</q:mn> <q:mo>±</q:mo> <q:mn>7.99</q:mn> </q:math> ; <s:math xmlns:s="http://www.w3.org/1998/Math/MathML" id="M10"> <s:mi>r</s:mi> <s:mo>=</s:mo> <s:mo>−</s:mo> <s:mn>0.55</s:mn> </s:math> ), and coping with symptoms ( <u:math xmlns:u="http://www.w3.org/1998/Math/MathML" id="M11"> <u:mi>r</u:mi> <u:mo>=</u:mo> <u:mo>−</u:mo> <u:mn>0.68</u:mn> </u:math> ). Physical activity levels showed positive moderate correlations with the self-efficacy in the domain of physical function ( <w:math xmlns:w="http://www.w3.org/1998/Math/MathML" id="M12"> <w:mi>r</w:mi> <w:mo>=</w:mo> <w:mn>0.41</w:mn> </w:math> ). Linear regression models determined that the self-efficacy and anxiety sensitivity with showed a significant relationship with the HIT-6 score ( <y:math xmlns:y="http://www.w3.org/1998/Math/MathML" id="M13"> <y:msup> <y:mrow> <y:mi>R</y:mi> </y:mrow> <y:mrow> <y:mn>2</y:mn> </y:mrow> </y:msup> <y:mo>=</y:mo> <y:mn>0.262</y:mn> <y:mo>;</y:mo> <y:mi>p</y:mi> <y:mo>=</y:mo> <y:mn>0.008</y:mn> </y:math> ) and with the ASI-3 score ( <ab:math xmlns:ab="http://www.w3.org/1998/Math/MathML" id="M14"> <ab:msup> <ab:mrow> <ab:mi>R</ab:mi> </ab:mrow> <ab:mrow> <ab:mn>2</ab:mn> </ab:mrow> </ab:msup> <ab:mo>=</ab:mo> <ab:mn>0.565</ab:mn> </ab:math> ; <cb:math xmlns:cb="http://www.w3.org/1998/Math/MathML" id="M15"> <cb:mi>p</cb:mi> <cb:mo>&lt;</cb:mo> <cb:mn>0.001</cb:mn> </cb:math> ). In addition, no correlations were found between pain intensity, duration or frecuency with psychosocial factors, or headache impact. Conclusions. The present study showed that patients with chronic tension-type headache had a great negative impact on daily tasks and physical activity levels, which were associated with higher anxiety levels and lower self-efficacy.

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