A Qualitative, Systems Thinking Approach to Study Self-Management in Women With Migraine

Area of Science:

• Neuroscience
• Public Health
• Sociology

Background:

• Migraine is a debilitating neurobiological condition with limited treatment options.
• Nonpharmacological self-management is essential for women living with migraine.
• Migraine disproportionately affects and disables women, particularly those in vulnerable social locations.

Purpose of the Study:

• To develop and apply a systems thinking, problem-structuring data collection approach for studying migraine self-management.
• To explore the self-management experiences of women with migraine in diverse social contexts.

Main Methods:

• Developed two systems mapping activities: a system support map for migraine episodes and a connection circle (CC) for self-management mental models.
• Utilized constant comparison analysis, theory, clinical experience, and participant feedback to refine the approach.
• Replaced the CC with a strengths-based problem-solving tool to better support participants.

Main Results:

• The initial connection circle (CC) approach overwhelmed marginalized women.
• A recalibrated, strengths-based problem-solving activity proved more effective and actionable for diverse participants.
• The revised approach highlighted relationships and trade-offs in self-management.

Conclusions:

• A critical, strengths-based approach can replace deficit thinking in healthcare for vulnerable populations.
• Systems thinking tools can illuminate complex self-management behaviors and challenges faced by women with migraine.
• Healthcare models must consider social and structural determinants of health and equity for effective migraine management.