Impact of primary headache disorder on quality of life among school students in Kuwait

DOI: https://doi.org/10.1186/s10194- 020- 01124- 3

Abstract-Summary Primary headache disorders have being increasingly reported in younger populations.

52

1 Public Health

To assess the burden of primary headache disorder and its impact on the quality

of life on school student in Kuwait.

A cross-sectional study was conducted among Kuwaiti primary and middle school students of both genders in randomly selected schools located in two gover- norates in 2018/2019 academic year.

Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire for children and adolescents was used to assess the impact of primary headaches on the quality of life.

One thousand and ninety-one questionnaires were completed by primary and middle school students of both genders; of whom 466 students (girls 321 (68.88%) were diagnosed with primary headache disorders with mean age 11.98 ± 2.03 years. Their parents lost a mean of 2 ± 2.03 days of work because of headaches of their children and parents prohibited 5.7% of the students to engage in any activity due to their headaches.

19.4% of students reported they did not want others noticing their headache. Primary headache disorder can have a significant impact on the quality of life in

children.

Implementing strategies to properly manage schoolchildren with primary head-

aches can have profound effects on their quality of life.

Extended: Once the burden is recognized, efforts can be implemented to improve not only the patients’ quality of life in the future leading to positive outcomes over time, but also their parents as it is also noted that their lives are limited with the responsibilities that are associated with taking care of their children [162].

It serves as a ground basis for future research investigations in attempt to imple-

ment the best interventions to tackle all the emotional and behavioral issues.

Introduction Headaches can significantly lead to debilitated cognitive, emotional and recreational functioning in all areas of life ranging from their homes to their scholar activi- ties [163].

Headache disorders are burdensome conditions has been reported in previ-

ous papers.

There are at least six main themes that have been associated to the broad concept of burden and impact of primary headache as its prevalence, its overall impact (mostly defined as reduced QoL or disability), impact on work or school activities, impact on family life, interictal burden and disease costs [164].

A research of this kind is conducted to shed light on the burden of such headache

disorders.

Methods We conducted a cross-sectional study with a school-based sample whereby a ques- tionnaire was distributed to primary and middle schoolchildren aged 7–16 years in governmental schools in Kuwait.

Equal numbers of boys and school girls are included in our study.

1.2

Personal and Societal Burden

53

The survey used Lifting the Burden, Headache-Attributed Restriction, Disability, Social Handicap and Impaired Participation (HARDSHIP) questionnaire that was translated into Arabic [43].

The Child HARDSHIP for children aged 6–11 years and Adolescent HARDSHIP

questionnaire for adolescents aged 12–17 years were used in this study.

Data were obtained from the children and adolescents themselves after explana-

tion of the questions by physician of the study team.

Questionnaire distribution and data collection were organized and conducted by

physician supervisors during a school class as a paper-pencil version.

To collect study data, well trained physicians conducted face to face interviews

using Child and Adolescent HARDSHIP questionnaires.

Results With respect to severity, majority of students labeled their headaches as ‘quite bad’, whereas few of students experienced ‘very bad’ headaches.

Majority of the students (51.5%) experienced a feeling of sadness ranging from

sometimes to always, on the other hand, 25% never experienced it.

Most of the students (67.3%) struggled to cope with the headache as (22.4%)

never was able to cope, while sometimes 48.1% could manage.

The greater number of the students were comfortable with people noticing their

headaches, in contrast to 19.4% who always did not want people to notice it.

Feeling bored was always experienced by 18.1% of the population, however, almost half of the remaining felt it sometimes (43%).50% of the children reported never feeling alone, followed by sometimes in (30.2%).

Feeling different from the other children was witnessed always in (9.7%) of the

students, nonetheless, (56.9%) never experienced it.

Discussion A previously published population-based study in Kuwait estimated that one-year prevalence of primary headache disorders in children and adolescents was 19.4% [165].

Studies that estimate the impact of primary headache in children are scarce. The burden of headache in children and adolescents in our results is in agreement with earlier results that revealed total scores of 17.8–44 days where pediatric head- ache patients were totally or partially disabled at home or at school because of their headache [166].

Majority of our cohort used symptomatic medications for headache on average 3.26 days a month, which is in agreement with earlier studies, which reported medi- cation use among children in a variable percentage ranging from 30% to 80% [167, 168].

The extent of headaches can lead to lack of attention and concentration which

was reported in our study participants as well as those in other researches [169].

Conclusions Recognizing the psychosocial effects induced by headaches is vital for the develop- ment of the best clinical and holistic care for the patients.

54

1 Public Health

Acknowledgement A machine generated summary based on the work of Al-Hashel, Jasem Y.; Alroughani, R.; Shuaibi, S.; AlAshqar, A.; AlHamdan, F.; AlThufairi, H.; Owayed, S.; Ahmed, Samar F. 2020 in The Journal of Headache and Pain.

Patients’ perspective on the burden of migraine in Europe: a cross-sectional analysis of survey data in France, Germany, Italy, Spain, and the United Kingdom