Learning Objective #1: Recognize that 15%(N=17) of a chronic headache sufferer sample were relating to their spouses in a functional way

Learning Objective #2: Recognize that 29%(N=34) of a chronic headache sufferer sample were relating to their spouses in rigid, chaotic, and conflictual ways

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The purpose of this study was to test Minuchin, Rosman, and Baker's Family Systems Theory (l978) with an adult chronic headache population that had not responded to conventional medical treatment prescribed by their primary care physicians. One hundred and twenty-one chronic headache sufferers were assessed for headache pain on their initial appointment at a specialty headache clinic, and again post–treatment and at 3 months follow-up using the McGill Pain Questionnaire. The chronic headache sufferers and their spouses were assessed for marital cohesion, adaptability, and conflict at these same points in time using the Family Adaptability and Cohesion Scale IV and the Dyadic Adjustment Scale. At pretreatment, 15% of the couples (N=17) were balanced and functional in relating to one another, 56% (N=66) were predominately rigid and moderately dysfunctional in relating to one another, and 29% (N=34) were rigid, chaotic, conflictual, and dysfunctional in relating to one another. Chronic headache sufferers perceived their marital transactions as more balanced than their spouses. Changes in rigidity and chaos were positively correlated with changes in pain at post-treatment. In conclusion, thirty-four adult chronic headache sufferers who presented at a specialty headache clinic and their spouses were in conflict with one another and related in rigid and chaotic ways. Their transactional patterns were similar to those seen by Minuchin in families with children who had uncontrollable diabetes, asthma, abdominal pain, and anorexia. The adult chronic headache sufferers' transactional patterns differed from Minuchin's families being chaotic verses enmeshed and over-protective. Nurses who treat chronic headache sufferers should be aware that some chronic headache sufferers may be experiencing marital conflict at the time of their initial appointment for pain management treatment. Nurses should assess for marital conflict in chronic headache sufferers and their spouses at the beginning of pain management treatment for chronic headaches.