Identifying Chinese Medicine patterns of Tension-type Headache (TTH) and its implication on understanding TTH subgroups
Background Acupuncture is commonly used to relieve tension-type of headache (TTH), however, there is a lack of consistent approach of devising acupuncture interventions for TTH due to limited evidence for symptom patterns according to Chinese medicine. This study aimed to identity common Chinese medicine symptom patterns of TTH.
Methods We applied a validated Chinese Medicine Headache Questionnaire to a group of headache sufferers. The questionnaire consisted of information about headache, aggravating and relieving factors and accompanying symptoms. The Migraine Disability Assessment Test (MIDAS) was used to assess disability and the Perceived Stress Scale (PSS) for the level of stress. Information about comorbidities was collected. The modified International Headache Society TTH diagnostic criteria (ICHD-II) were used to screen the participants. Principal component analysis was used for factor extraction and Two-Step cluster analyses for clustering. One-way analysis of variance (ANOVA) was used to compare cluster groups in disability and stress.
Results In total 170 participants, including 114 females and 56 males, met the selection criteria. The commonest headache features were continuous pain (64%) and fixed location (74%). Headache was aggravated by overwork (74%), stress (74%), and mental strain (70%) and relieved by sleeping (78%). The commonest accompanied symptoms were fatigue (71%) and neck stiffness (70%). Four clusters were identified with 46, 34, 46 and 44 participants in Clusters 1-4, respectively. Assessed by experts, the four clusters could be assigned to three different patterns, including Ascendant hyperactivity of Liver-Yang (Cluster 1), Dual Qi and Blood deficiency (Cluster 2), Liver depression forming Fire (Cluster 3), and an Un-labelled group (Cluster 4). The four clusters differed in their key signs and symptoms. Additionally, over 75% participants in clusters 1 and 2 were episodic TTH, over one third in Cluster 3 having chronic TTH, and the majority in Cluster 4 were in-frequent TTH. The three patterns identified also differed in levels of disability and some elements of coping as measured with PSS.
Conclusion The three symptom patterns identified are common clinical presentations of TTH. The new information will contribute to further understanding of the subtypes of TTH and guide the development of targeted interventions, including acupuncture, for clinical practice and research.
Figure 1
Figure 2
|
Frequency (n) |
Percent (%) |
Gender (n=170) |
||
Women |
120 |
70.6 |
Men |
50 |
29.4 |
Age range (n=166) |
||
20-29 |
55 |
33.1 |
30-39 |
44 |
26.5 |
40-49 |
31 |
18.7 |
50-59 |
26 |
15.7 |
60+ |
10 |
6.0 |
Marital status (n=165) |
||
Single |
64 |
38.8 |
Married |
77 |
46.7 |
Partnered |
9 |
5.5 |
Divorced |
13 |
7.9 |
Separated |
2 |
1.2 |
Ethnicity distribution (n=164) |
||
Chinese Asian |
79 |
48.2 |
Australian Peoples |
42 |
25.6 |
British |
13 |
7.9 |
New Zealand Peoples |
3 |
1.8 |
Southern European |
3 |
1.8 |
Irish |
3 |
1.8 |
Western European |
3 |
1.8 |
South Eastern European |
1 |
.6 |
Northern European |
1 |
.6 |
Eastern European |
1 |
.6 |
Maritime South-East Asian |
1 |
.6 |
Arab |
1 |
.6 |
Central Asian |
1 |
.6 |
Mainland South-East Asian |
1 |
.6 |
Southern Asian |
1 |
.6 |
Other north-east Asian |
1 |
.6 |
Other Asian |
1 |
.6 |
Had more than one ethnicity |
8 |
4.9 |
Level of education (n=164) |
||
Postgraduate degree level |
40 |
24.4 |
Graduate diploma and graduate certificate level |
8 |
4.9 |
Bachelor degree level |
72 |
43.9 |
Advanced diploma and diploma level |
18 |
11.0 |
TAFE level |
10 |
6.1 |
Secondary education |
14 |
8.5 |
Primary education |
2 |
1.2 |
CMHQ PART1 Pain description |
CMHQ PART2 Aggravating & relieving factors |
CMHQ PART3 Accompanying symptoms |
FAC1.1F1CentralHead |
FAC 2.1F1Mental |
FAC 3.1F1LiverQi&Fire |
FAC 1.1F2WholeHead |
FAC 2.1F2Food |
FAC 3.1F2Eye |
FAC 1.1F3LateralHead |
FAC 2.1F3WeatherChange |
FAC 3.1F3BoneJointWind |
FAC 1.3F1RhythmHeadache |
FAC 2.1F4NoFood&Drink |
FAC 3.1F4PoorDigestion |
FAC 1.3F2ExplosiveNotDull |
FAC 2.1F5MentalStrain |
FAC 3.1F5LiverSpleenFire |
FAC 1.3F3SharpHeadache |
FAC 2.1F6MuscularStrain |
FAC 3.1F6YinDeficiency |
FAC 1.3F4TightHeadache |
FAC 2.1F7Oil&Spicy |
FAC 3.1F7LiverAttackStomach |
FAC 1.3F7DistendingHeadache |
FAC 2.1F8WindDamp |
FAC 3.1F8ENT |
FAC 1.3F8EmptyHeadache |
FAC 2.1F9PhysicalStrain |
FAC 3.1F9LightSound |
FAC 1.5F1LateOfDay |
FAC 2.1F10Alcohol-DragCigar |
FAC 3.1F10TemperatureSensitivity |
FAC 1.5F2BothEnd |
FAC 2.2F1Rest |
FAC 3.1F11Constipation |
FAC 1.5F3AllDay |
FAC 2.2F2PhysicalStimulation |
FAC 3.1F12BloodDeficiency |
FAC 2.2F3EatingRelated |
FAC 3.1F13YangDeficiency |
|
FAC 3.1F14SpleenDeficienyOfBowel |
||
FAC 3.1F16Tinnitus |
||
FAC 3.1F17Insomnia |
||
Included: n=12 |
Included: n=13 |
Included: n=16 |
* In this table, “FAC” is the abbreviation of “factor”, whereas the numbers 1.X after it indicate their section number. For instance, FAC1.6F1 denotes the extracted first factor of Section 1.6, which summarised items of Forehead, Back of the head, and Top of the head. |
Cluster 1 (n=46) |
Cluster 2 (n=34) |
Cluster 3 (n=46) |
Cluster 4 (n=44) |
||
Location & Quality |
• Forehead; Back of the head; Top of the head • PAIN QUALITY: Throbbing; Pulsating; Pounding; Tight; A “band-like” sensation |
• Forehead, Back of the head, Top of the head; Both side of the head • PAIN QUALITY: Throbbing; Pulsating; Pounding • Worse in the morning and at night; All day |
Whole head; No particular location |
Explosive; NOT Dull; Sharp; Piercing |
|
Aggravating & Relieving factors |
AGGRAVATING BY: Dehydration Hunger / Being hungry Chocolate Muscular strain(muscle tightness) Poor posture in sitting, standing or sleeping Teeth grinding |
AGGRAVATING BY: Change of weather; Change in temperature; Hot weather; Cold weather; Dehydration; Hunger; Chocolate |
RELIEVING BY: Exercise; Massage Pressing the pain area; Warmth Coldness; Medication; Eating |
AGGRAVATING BY: Stress; Nervousness Irritability Excessive worry; Depression Tension or conflict related |
AGGRAVATING BY: Windy days Damp weather / Humid weather Rainy days
|
Accompanying symptoms |
Sensitivity to light (or to bright lights) Sensitivity to sound |
“Pins and needles” or numbness in the hands and feet; Faintness; Dizziness; Watery bowel motion; Loose bowel motion |
Dry mouth; Thirst; Bitter taste in the mouth |
Belching; Bloating; Indigestion; Fear of being hot |
|
|
TTH clusters |
Total (n) |
p-value† Chi-Square |
p-value† ANOVA |
||||
C1 |
C2 |
C3 |
C4 |
|
|
|
||
Age |
44 v.34 |
33 v.4 |
37 v.1 |
29 v.12 |
143 |
N/A |
0.000*05 |
|
Gender (n) |
F |
35 |
27 |
30 |
28 |
120 |
.307 |
N/A |
M |
11 |
7 |
16 |
16 |
50 |
|||
Age range |
20-29 |
6 |
8 |
17 |
24 |
55 |
.001*0125 |
N/A |
20-29 |
10 |
12 |
10 |
12 |
44 |
|||
20-29 |
10 |
8 |
6 |
7 |
31 |
|||
20-29 |
14 |
4 |
8 |
0 |
26 |
|||
20-29 |
5 |
2 |
2 |
1 |
10 |
|||
Marriage status |
Single |
13 |
10 |
16 |
25 |
64 |
.047 |
N/A |
Married |
22 |
15 |
25 |
14 |
77 |
|||
Partnered |
3 |
4 |
0 |
2 |
9 |
|||
Divorced |
6 |
4 |
1 |
2 |
13 |
|||
Separated |
0 |
1 |
0 |
1 |
2 |
|||
Education level |
Postgraduate |
13 |
8 |
8 |
11 |
40 |
.968 |
N/A |
Graduate |
3 |
2 |
1 |
2 |
8 |
|||
Bachelor |
17 |
14 |
21 |
20 |
72 |
|||
Diploma |
4 |
5 |
3 |
6 |
19 |
|||
TAFE |
4 |
1 |
3 |
2 |
10 |
|||
Secondary Edu |
4 |
4 |
4 |
2 |
14 |
|||
Primary Edu |
0 |
0 |
1 |
1 |
2 |
|||
Ethnicity |
Oceania |
19 |
18 |
4 |
4 |
45 |
.000*0125 |
N/A |
European |
14 |
7 |
2 |
2 |
25 |
|||
Arab |
0 |
0 |
1 |
0 |
1 |
|||
Asian |
7 |
5 |
35 |
38 |
85 |
|||
had > 1 ethnicity |
5 |
3 |
0 |
0 |
8 |
|||
TTH subtypes n (%) |
Infrequent ETTH |
1(2%) |
1(3%) |
7(15%) |
15(34%) |
24(14%) |
.000*0125 |
N/A |
Frequent ETTH |
36(78%) |
26(76%) |
23(50%) |
22(50%) |
107(63%) |
|||
CTTH |
9(20%) |
7(21%) |
16(35%) |
7(16%) |
39(23%) |
|||
MIDAS item
|
Q1 |
44(1.07) |
33(2.30) |
43(2.74) |
44(3.86) |
164(7.771) |
N/A |
.408 |
Q2 |
44(5.34) |
33(9.67) |
43(9.81) |
44(5.50) |
164(7.43) |
N/A |
.157 |
|
Q3 |
44(3.95) |
33(6.82) |
43(4.00) |
44(3.23) |
164(4.35) |
N/A |
.209 |
|
Q4 |
44(6.05) |
33(8.15) |
43(4.35) |
44(2.93) |
164(5.19) |
N/A |
.038*05 |
|
Q5 |
44(2.18) |
33(4.24)) |
432.65 |
443.86 |
164(3.17) |
N/A |
.606 |
|
MIDAS A |
44(20.45) |
33(26.73) |
43(20.53) |
44(15.82) |
164(20.49) |
N/A |
.259 |
|
MIDAS B |
44(5.45) |
33(6.30) v.4 |
43(5.42) |
44(4.68) v.2 |
164(5.41) |
N/A |
.015*05 |
|
MIDAS SUM (mean score) |
44(18.59) |
33(31.18) |
43(23.56) |
44(19.39) |
164(22.64) |
N/A |
.310 |
|
MIDAS disability level n (%) |
Level 1 |
12(27%) |
3(1%) |
14(33%) |
22(50%) |
51(31%) |
.017*05 |
N/A |
Level 2 |
5(11%) |
7(21%) |
3(7%) |
4(9%) |
19(12%) |
|||
Level 3 |
14(32%) |
8(24%) |
8(19%) |
7(16%) |
37(23%) |
|||
Level 4 |
13(30%) |
15(45%) |
18(42%) |
11(25%) |
57(35%) |
|||
PSS score (score by item) |
Sum |
16.68 |
16.19 |
18.79 |
15.11 |
16.72 |
N/A |
.092 |
Perceived Distress |
9.85 |
10.06 |
10.22 |
7.52 |
9.39 |
N/A |
.066 |
|
Perceived Coping |
5.04 v.3,4 |
5.18 v.3,4 |
7.35* v.1,2 |
7.59* v.1,2 |
6.35 |
N/A |
.000*017 |
|
Comorbidity Checklist (number of items) |
Somatic comorbidity |
46 |
34 |
46 |
44 |
42.9% |
.588 |
N/A |
Mental comorbidity |
8 |
9 |
5 |
0 |
12.9% |
.060 |
N/A |
|
Note 1: Australia is a county of immigration. In section of ethnicity, the category of “had more than 1 ethnicity” indicated a group of participants in this country share more than one ethnicity. For example, an Australian person may have his/her mother of Irish ethnicity and father of Greek. In such case, these participants may tick two options and in data analysis, he/she was classified as participant had more than one ethnicity. Note 2: Both Chi-Square and ANOVA were applied to access cluster differences for comparison. Chi-Square tests examine categorical outcomes, whereas ANOVA assess the means of each cluster. p values correspond to comparisons between the clusters using Chi-square test or ANOVA, as appropriate *05. The mean difference is significant at the 0.05 level. *0125. The mean difference is significant at the 0.0125(0.05/4) level. *017. The mean difference is significant at the 0.017(0.05/3) level. “v.”. denotes the clusters differed with post-hoc Bonferroni correction, whereas the “x(figure)” after “v.” indicates specific cluster or clusters. |
[Due to technical limitations, table 5 could not be displayed here. Please see the supplementary files section to access table 5.]
This is a list of supplementary files associated with this preprint. Click to download.
Posted 31 Dec, 2019
Identifying Chinese Medicine patterns of Tension-type Headache (TTH) and its implication on understanding TTH subgroups
Posted 31 Dec, 2019
Background Acupuncture is commonly used to relieve tension-type of headache (TTH), however, there is a lack of consistent approach of devising acupuncture interventions for TTH due to limited evidence for symptom patterns according to Chinese medicine. This study aimed to identity common Chinese medicine symptom patterns of TTH.
Methods We applied a validated Chinese Medicine Headache Questionnaire to a group of headache sufferers. The questionnaire consisted of information about headache, aggravating and relieving factors and accompanying symptoms. The Migraine Disability Assessment Test (MIDAS) was used to assess disability and the Perceived Stress Scale (PSS) for the level of stress. Information about comorbidities was collected. The modified International Headache Society TTH diagnostic criteria (ICHD-II) were used to screen the participants. Principal component analysis was used for factor extraction and Two-Step cluster analyses for clustering. One-way analysis of variance (ANOVA) was used to compare cluster groups in disability and stress.
Results In total 170 participants, including 114 females and 56 males, met the selection criteria. The commonest headache features were continuous pain (64%) and fixed location (74%). Headache was aggravated by overwork (74%), stress (74%), and mental strain (70%) and relieved by sleeping (78%). The commonest accompanied symptoms were fatigue (71%) and neck stiffness (70%). Four clusters were identified with 46, 34, 46 and 44 participants in Clusters 1-4, respectively. Assessed by experts, the four clusters could be assigned to three different patterns, including Ascendant hyperactivity of Liver-Yang (Cluster 1), Dual Qi and Blood deficiency (Cluster 2), Liver depression forming Fire (Cluster 3), and an Un-labelled group (Cluster 4). The four clusters differed in their key signs and symptoms. Additionally, over 75% participants in clusters 1 and 2 were episodic TTH, over one third in Cluster 3 having chronic TTH, and the majority in Cluster 4 were in-frequent TTH. The three patterns identified also differed in levels of disability and some elements of coping as measured with PSS.
Conclusion The three symptom patterns identified are common clinical presentations of TTH. The new information will contribute to further understanding of the subtypes of TTH and guide the development of targeted interventions, including acupuncture, for clinical practice and research.
Figure 1
Figure 2
|
Frequency (n) |
Percent (%) |
Gender (n=170) |
||
Women |
120 |
70.6 |
Men |
50 |
29.4 |
Age range (n=166) |
||
20-29 |
55 |
33.1 |
30-39 |
44 |
26.5 |
40-49 |
31 |
18.7 |
50-59 |
26 |
15.7 |
60+ |
10 |
6.0 |
Marital status (n=165) |
||
Single |
64 |
38.8 |
Married |
77 |
46.7 |
Partnered |
9 |
5.5 |
Divorced |
13 |
7.9 |
Separated |
2 |
1.2 |
Ethnicity distribution (n=164) |
||
Chinese Asian |
79 |
48.2 |
Australian Peoples |
42 |
25.6 |
British |
13 |
7.9 |
New Zealand Peoples |
3 |
1.8 |
Southern European |
3 |
1.8 |
Irish |
3 |
1.8 |
Western European |
3 |
1.8 |
South Eastern European |
1 |
.6 |
Northern European |
1 |
.6 |
Eastern European |
1 |
.6 |
Maritime South-East Asian |
1 |
.6 |
Arab |
1 |
.6 |
Central Asian |
1 |
.6 |
Mainland South-East Asian |
1 |
.6 |
Southern Asian |
1 |
.6 |
Other north-east Asian |
1 |
.6 |
Other Asian |
1 |
.6 |
Had more than one ethnicity |
8 |
4.9 |
Level of education (n=164) |
||
Postgraduate degree level |
40 |
24.4 |
Graduate diploma and graduate certificate level |
8 |
4.9 |
Bachelor degree level |
72 |
43.9 |
Advanced diploma and diploma level |
18 |
11.0 |
TAFE level |
10 |
6.1 |
Secondary education |
14 |
8.5 |
Primary education |
2 |
1.2 |
CMHQ PART1 Pain description |
CMHQ PART2 Aggravating & relieving factors |
CMHQ PART3 Accompanying symptoms |
FAC1.1F1CentralHead |
FAC 2.1F1Mental |
FAC 3.1F1LiverQi&Fire |
FAC 1.1F2WholeHead |
FAC 2.1F2Food |
FAC 3.1F2Eye |
FAC 1.1F3LateralHead |
FAC 2.1F3WeatherChange |
FAC 3.1F3BoneJointWind |
FAC 1.3F1RhythmHeadache |
FAC 2.1F4NoFood&Drink |
FAC 3.1F4PoorDigestion |
FAC 1.3F2ExplosiveNotDull |
FAC 2.1F5MentalStrain |
FAC 3.1F5LiverSpleenFire |
FAC 1.3F3SharpHeadache |
FAC 2.1F6MuscularStrain |
FAC 3.1F6YinDeficiency |
FAC 1.3F4TightHeadache |
FAC 2.1F7Oil&Spicy |
FAC 3.1F7LiverAttackStomach |
FAC 1.3F7DistendingHeadache |
FAC 2.1F8WindDamp |
FAC 3.1F8ENT |
FAC 1.3F8EmptyHeadache |
FAC 2.1F9PhysicalStrain |
FAC 3.1F9LightSound |
FAC 1.5F1LateOfDay |
FAC 2.1F10Alcohol-DragCigar |
FAC 3.1F10TemperatureSensitivity |
FAC 1.5F2BothEnd |
FAC 2.2F1Rest |
FAC 3.1F11Constipation |
FAC 1.5F3AllDay |
FAC 2.2F2PhysicalStimulation |
FAC 3.1F12BloodDeficiency |
FAC 2.2F3EatingRelated |
FAC 3.1F13YangDeficiency |
|
FAC 3.1F14SpleenDeficienyOfBowel |
||
FAC 3.1F16Tinnitus |
||
FAC 3.1F17Insomnia |
||
Included: n=12 |
Included: n=13 |
Included: n=16 |
* In this table, “FAC” is the abbreviation of “factor”, whereas the numbers 1.X after it indicate their section number. For instance, FAC1.6F1 denotes the extracted first factor of Section 1.6, which summarised items of Forehead, Back of the head, and Top of the head. |
Cluster 1 (n=46) |
Cluster 2 (n=34) |
Cluster 3 (n=46) |
Cluster 4 (n=44) |
||
Location & Quality |
• Forehead; Back of the head; Top of the head • PAIN QUALITY: Throbbing; Pulsating; Pounding; Tight; A “band-like” sensation |
• Forehead, Back of the head, Top of the head; Both side of the head • PAIN QUALITY: Throbbing; Pulsating; Pounding • Worse in the morning and at night; All day |
Whole head; No particular location |
Explosive; NOT Dull; Sharp; Piercing |
|
Aggravating & Relieving factors |
AGGRAVATING BY: Dehydration Hunger / Being hungry Chocolate Muscular strain(muscle tightness) Poor posture in sitting, standing or sleeping Teeth grinding |
AGGRAVATING BY: Change of weather; Change in temperature; Hot weather; Cold weather; Dehydration; Hunger; Chocolate |
RELIEVING BY: Exercise; Massage Pressing the pain area; Warmth Coldness; Medication; Eating |
AGGRAVATING BY: Stress; Nervousness Irritability Excessive worry; Depression Tension or conflict related |
AGGRAVATING BY: Windy days Damp weather / Humid weather Rainy days
|
Accompanying symptoms |
Sensitivity to light (or to bright lights) Sensitivity to sound |
“Pins and needles” or numbness in the hands and feet; Faintness; Dizziness; Watery bowel motion; Loose bowel motion |
Dry mouth; Thirst; Bitter taste in the mouth |
Belching; Bloating; Indigestion; Fear of being hot |
|
|
TTH clusters |
Total (n) |
p-value† Chi-Square |
p-value† ANOVA |
||||
C1 |
C2 |
C3 |
C4 |
|
|
|
||
Age |
44 v.34 |
33 v.4 |
37 v.1 |
29 v.12 |
143 |
N/A |
0.000*05 |
|
Gender (n) |
F |
35 |
27 |
30 |
28 |
120 |
.307 |
N/A |
M |
11 |
7 |
16 |
16 |
50 |
|||
Age range |
20-29 |
6 |
8 |
17 |
24 |
55 |
.001*0125 |
N/A |
20-29 |
10 |
12 |
10 |
12 |
44 |
|||
20-29 |
10 |
8 |
6 |
7 |
31 |
|||
20-29 |
14 |
4 |
8 |
0 |
26 |
|||
20-29 |
5 |
2 |
2 |
1 |
10 |
|||
Marriage status |
Single |
13 |
10 |
16 |
25 |
64 |
.047 |
N/A |
Married |
22 |
15 |
25 |
14 |
77 |
|||
Partnered |
3 |
4 |
0 |
2 |
9 |
|||
Divorced |
6 |
4 |
1 |
2 |
13 |
|||
Separated |
0 |
1 |
0 |
1 |
2 |
|||
Education level |
Postgraduate |
13 |
8 |
8 |
11 |
40 |
.968 |
N/A |
Graduate |
3 |
2 |
1 |
2 |
8 |
|||
Bachelor |
17 |
14 |
21 |
20 |
72 |
|||
Diploma |
4 |
5 |
3 |
6 |
19 |
|||
TAFE |
4 |
1 |
3 |
2 |
10 |
|||
Secondary Edu |
4 |
4 |
4 |
2 |
14 |
|||
Primary Edu |
0 |
0 |
1 |
1 |
2 |
|||
Ethnicity |
Oceania |
19 |
18 |
4 |
4 |
45 |
.000*0125 |
N/A |
European |
14 |
7 |
2 |
2 |
25 |
|||
Arab |
0 |
0 |
1 |
0 |
1 |
|||
Asian |
7 |
5 |
35 |
38 |
85 |
|||
had > 1 ethnicity |
5 |
3 |
0 |
0 |
8 |
|||
TTH subtypes n (%) |
Infrequent ETTH |
1(2%) |
1(3%) |
7(15%) |
15(34%) |
24(14%) |
.000*0125 |
N/A |
Frequent ETTH |
36(78%) |
26(76%) |
23(50%) |
22(50%) |
107(63%) |
|||
CTTH |
9(20%) |
7(21%) |
16(35%) |
7(16%) |
39(23%) |
|||
MIDAS item
|
Q1 |
44(1.07) |
33(2.30) |
43(2.74) |
44(3.86) |
164(7.771) |
N/A |
.408 |
Q2 |
44(5.34) |
33(9.67) |
43(9.81) |
44(5.50) |
164(7.43) |
N/A |
.157 |
|
Q3 |
44(3.95) |
33(6.82) |
43(4.00) |
44(3.23) |
164(4.35) |
N/A |
.209 |
|
Q4 |
44(6.05) |
33(8.15) |
43(4.35) |
44(2.93) |
164(5.19) |
N/A |
.038*05 |
|
Q5 |
44(2.18) |
33(4.24)) |
432.65 |
443.86 |
164(3.17) |
N/A |
.606 |
|
MIDAS A |
44(20.45) |
33(26.73) |
43(20.53) |
44(15.82) |
164(20.49) |
N/A |
.259 |
|
MIDAS B |
44(5.45) |
33(6.30) v.4 |
43(5.42) |
44(4.68) v.2 |
164(5.41) |
N/A |
.015*05 |
|
MIDAS SUM (mean score) |
44(18.59) |
33(31.18) |
43(23.56) |
44(19.39) |
164(22.64) |
N/A |
.310 |
|
MIDAS disability level n (%) |
Level 1 |
12(27%) |
3(1%) |
14(33%) |
22(50%) |
51(31%) |
.017*05 |
N/A |
Level 2 |
5(11%) |
7(21%) |
3(7%) |
4(9%) |
19(12%) |
|||
Level 3 |
14(32%) |
8(24%) |
8(19%) |
7(16%) |
37(23%) |
|||
Level 4 |
13(30%) |
15(45%) |
18(42%) |
11(25%) |
57(35%) |
|||
PSS score (score by item) |
Sum |
16.68 |
16.19 |
18.79 |
15.11 |
16.72 |
N/A |
.092 |
Perceived Distress |
9.85 |
10.06 |
10.22 |
7.52 |
9.39 |
N/A |
.066 |
|
Perceived Coping |
5.04 v.3,4 |
5.18 v.3,4 |
7.35* v.1,2 |
7.59* v.1,2 |
6.35 |
N/A |
.000*017 |
|
Comorbidity Checklist (number of items) |
Somatic comorbidity |
46 |
34 |
46 |
44 |
42.9% |
.588 |
N/A |
Mental comorbidity |
8 |
9 |
5 |
0 |
12.9% |
.060 |
N/A |
|
Note 1: Australia is a county of immigration. In section of ethnicity, the category of “had more than 1 ethnicity” indicated a group of participants in this country share more than one ethnicity. For example, an Australian person may have his/her mother of Irish ethnicity and father of Greek. In such case, these participants may tick two options and in data analysis, he/she was classified as participant had more than one ethnicity. Note 2: Both Chi-Square and ANOVA were applied to access cluster differences for comparison. Chi-Square tests examine categorical outcomes, whereas ANOVA assess the means of each cluster. p values correspond to comparisons between the clusters using Chi-square test or ANOVA, as appropriate *05. The mean difference is significant at the 0.05 level. *0125. The mean difference is significant at the 0.0125(0.05/4) level. *017. The mean difference is significant at the 0.017(0.05/3) level. “v.”. denotes the clusters differed with post-hoc Bonferroni correction, whereas the “x(figure)” after “v.” indicates specific cluster or clusters. |
[Due to technical limitations, table 5 could not be displayed here. Please see the supplementary files section to access table 5.]