压力源及压力反应对大学生偏头痛患者日常生活的影响

Impact of stressors and stress responses on the daily life of college students with migraine

背景压力与偏头痛发作密切相关,但既往研究关于压力源及压力反应对大学生偏头痛人群日常生活的影响不明确。目的 探讨压力源及压力反应对大学生偏头痛人群日常生活的影响,以期为改善大学生偏头痛人群的日常生活提供参考。方法 于2018年8月—2019年8月,采用随机抽样,选取符合《国际头痛疾病分类(第3版)》(ICHD-3)偏头痛诊断标准的458名川北医学院在校大学生为研究对象,采用自编问卷收集大学生一般资料和头痛特征,采用头痛影响测试量表(HIT-6)评定偏头痛对大学生日常生活的影响。采用学生生活应激问卷(SLSI)评定压力源及压力反应,采用汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表24项版(HAMD-24)评定大学生的焦虑症状和抑郁症状。采用Pearson相关分析考查HIT-6评分与各量表评分之间的相关性,采用多元线性回归分析大学生偏头痛人群日常生活的影响因素。结果 SLSI中的挫折(r=0.138,P<0.01)、冲突(r=0.168,P<0.01)、压力(r=0.157,P<0.01)、变化(r=0.148,P<0.01)、自我强加(r=0.158,P<0.01)五个维度的压力源以及生理反应(r=0.256,P<0.01)、情绪反应(r=0.241,P<0.01)、行为反应(r=0.164,P<0.01)、HAMA总评分(r=0.192,P<0.01)、HAMD-24总评分(r=0.250,P<0.01)、SLSI总评分(r=0.250,P<0.01)与HIT-6评分均呈正相关,认知反应(r=-0.104,P<0.05)与HIT-6评分呈负相关。多元线性回归分析结果显示,生理反应(β=0.140,P<0.05)、焦虑(β=0.159,P<0.05)、认知反应(β=-0.091,P<0.05)可预测大学生偏头痛人群日常生活受影响的程度。结论 生理反应、认知反应、焦虑可能是大学生偏头痛人群日常生活的影响因素。

Background Stress is closely related to migraine attacks,however,previous studies on stressors,stress responses and their impact on the daily life of college students with migraine remain unclear.Objective To explore the impact of stressors and stress responses on the daily life of college students with migraine,in order to provide references for improving daily life of this population.Methods From August 2018 to August 2019,458 students from North Sichuan Medical College who met the International Classification of Headache Diseases third edition(ICHD-3),were selected using random sampling method.General data and headache characteristics were collected.The 6-item Headache Impact Test Questionnaire(HIT-6)was used to assess the impact of migraine on daily life.Student-Life Stress Inventory(SLSI)was used to assess the stressors and stress responses.Hamilton Anxiety Scale(HAMA)and Hamilton Depression Scale-24 item(HAMD-24)were used to assess anxiety and depressive symptoms.Pearson correlation analysis were used to examine the relationship between HIT-6 score and scores on various scales.Multiple linear regression was used to analyze the influencing factors on daily life in college students with migraine.Results In the SLSI,stressors in the dimensions of frustration(r=0.138,P<0.01),conflict(r=0.168,P<0.01),pressure(r=0.157,P<0.01),change(r=0.148,P<0.01),self-imposed(r=0.158,P<0.01),as well as physiological response(r=0.256,P<0.01),emotional response(r=0.241,P<0.01),behavioral response(r=0.164,P<0.01),HAMA total score(r=0.192,P<0.01),dHAMD-24 total score(r=0.250,P<0.01),and SLSI total score(r=0.250,P<0.01),were positively correlated with HIT-6 score.Cognitive response(r=-0.104,P<0.05)was negatively correlated with HIT-6 score.Stepwise multiple linear regression revealed that physiological response(β=0.140,P<0.05),anxiety(β=0.159,P<0.05),and cognitive response(β=-0.091,P<0.05)could predict the impact on daily life of college students with migraine.Conclusion Physiological response,cognitive response and anxiety may be the independent influencing factors on the daily life of college students with migraine.