DOI: 10.4103/nsn.nsn_111_25 ISSN: 2636-865X

Pain Acceptance: A New Perspective on Migraine-related Disability

Esra Kochan Kizilkiliç, Bekir Burak Kilboz, Metehan Karahoca, Elif Ünal, Tugrul Aydin, Serap Üçler
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BSTRACT

Background:

Migraine is a significant cause of disability, especially in women and adults aged 25–55 years. Biobehavioral techniques provide nonpharmacologic strategies that circumvent the undesirable effects of medications. The acceptance of pain is becoming recognized in migraine management, yet headache-specific assessments remain limited. The Headache Acceptance Questionnaire (HAQ) addresses this gap as a headache-specific measure of pain acceptance. Following translation and cultural adaptation, we evaluated the correlation between HAQ scores and migraine-related impairment.

Methods:

In a cross-sectional cohort from a tertiary clinic (February to December 2024), the six-item HAQ was translated and adapted per standard guidance. We included 184 patients with migraine (156 women). Correlations tested associations between HAQ and disability indices, specifically the Headache Impact Test-6 (HIT-6), and the Migraine Disability Assessment Scale (MIDAS).

Results:

The Turkish HAQ demonstrated excellent content and structural validity (Kaiser-Meyer-Olkin = 0.89; Bartlett P < 0.001). A good fit was achieved on two-factor structure on factor analyses. Reliability was high (Cronbach’s α = 0.91; intraclass correlation coefficient = 0.99). HAQ scores showed strong inverse correlations with MIDAS ( r = −0.73, P < 0.001) and HIT-6 ( r = −0.86, P < 0.001), indicating that greater acceptance corresponded with lower disability.

Conclusions:

The Turkish HAQ is a valid, reliable instrument for headache-specific acceptance. Higher acceptance aligns with less migraine-related disability, underscoring clinical utility and the relevance of acceptance-based therapies.

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