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 ( $61.05\pm 6.38$ ) score showed significant moderate positive correlations with the ASI-3 score ( $17.64\pm 16.22$ ; $r=0.47$ ) and moderate negative correlations with the self-efficacy in the domains of pain management ( $31.9\pm 10.28$ ; $r=-0.43$ ) and coping with symptoms ( $53.81\pm 14.19$ ; $r=-0.47$ ). ASI-3 score had a negative large correlation with self-efficacy in the domains of pain management ( $r=-0.59$ ), physical function ( $53.36\pm 7.99$ ; $r=-0.55$ ), and coping with symptoms ( $r=-0.68$ ). Physical activity levels showed positive moderate correlations with the self-efficacy in the domain of physical function ( $r=0.41$ ). Linear regression models determined that the self-efficacy and anxiety sensitivity with showed a significant relationship with the HIT-6 score ( $R^2=0.262;p=0.008$ ) and with the ASI-3 score ( $R^2=0.565$ ; $p<0.001$ ). 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.