Study of Barrier to Help Seeking and its Relationships with Disability in Patients with Headache

• Main Authors: Deepa John, Dushad Ram, Harsha Sundarmurthy, Harshal Rathod, Snehal Rathod
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2016-10-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: functional impairment; illness behaviour; treatment barriers
• Online Access: https://jcdr.net/articles/PDF/8621/22624_CE[Ra1]_F(GH)_PF1(VSUAK)_PFA(AK)_PF2(PAG).pdf
• ISSN: 2249-782X; 0973-709X

Introduction: Headache is among the first three most prevalent disorders with a wide treatment gap due to barriers in help seeking. Headache has been associated with disability. However, the relationship of barriers to help-seeking and disability are unexplored. Aim: To find out the barriers to help seeking and its relationship with headache related disability in patients with headache. Materials and Methods: In this hospital based cross-sectional study, 200 consecutive subjects with headache attending a tertiary care centre were recruited as per selection criteria and assessed with Sociodemographic & Clinical Proforma, Mini International Neuropsychiatric Interview (MINI), Barriers to Help Seeking Scale (BHSS), The Henry Ford Hospital Headache Disability Inventory (HDI). Results: High mean score was observed on BHSS subscale need for control and self reliance (19.45; SD ±9.66) and minimizing problem and resignation (10.02; SD ±6.98). Mean score on the HDI was 25.65 (SD ± 14.09). Socioeconomic status of the patient was statistically significant and positively associated with need for control and self reliance (p=0.035), concrete barriers and distrust of care givers (p=0.039), emotional control (p=0.005), and privacy (p=0.002). Occupational status had significant association with need for control and self-reliance (p=0.01), minimizing problem and resignation (p=0.033), and emotional control (p=0.006). Score on hospital headache disability inventory significantly predicted the value of score on concrete barriers and distrust of caregivers domain of HDI (p=0.001). Conclusion: Autonomy and under estimation of seriousness of headache are common barriers to help seeking. Pattern of help seeking barriers may vary with socio-economic status and occupational status, while disability varies with gender and severity of headache. Headache associated disability is positively associated with concrete barriers.