How do patients with chronic headache manage their personal goals? – a qualitative study

Abstract

Background: A chronic headache disorder poses many limitations to the pursuit and attainment of personal goals. Self-regulation theories suggest that effective goal-management may help patients to keep pursuing goals and maintain well-being despite these limitations. The aim of this qualitative study was to gain insight into the use of goal management strategies in the context of chronic headache. Methods: In depth interviews were conducted with 20 patients with chronic headache. Data were coded and analysed following the Hutter-Hennink Qualitative Research Cycle. Deductive codes were derived from the Dual Process Model (DPM), Motivational Theory of life-span Development (MTD) and the model of Selection, Optimization and Compensation (SOC). Thematic analysis was used to inductively identify themes that are not covered by theory. Findings: CH patients report a chronic lack of resources (e.g., time, energy). To be able to pursue multiple goals, they report using a combination of assimilative (e.g., prioritizing goals, using medication) and accommodative (e.g., giving up goals) strategies. A good balance between the two seems to be imperative to maintaining health and well-being in the context of CH. Patients indicate to obtain this balance through a continuous and dynamic process of monitoring goals and resources, accepting limitations, and making conscious decisions about which goals to pursue. Discussion: The current study gives insight into the complexity of goal management in the context of CH and highlights the relevance of meta-regulatory processes. The complex everyday dynamics of goal management are currently not adequately captured by existing assessment methods.