Table 5.

Social Role Functioning Concepts

Concept	# Interviews Coded	Definition	Example Quotes
Work	58	Ability to work at a paying job	It wasn’t till later that retrospectively I looked at all the jobs I had or the problems I’ve had with my jobs, and they were probably all caused by the fact that I was in pain. I miss work all the time. And this feeling of like - I can’t miss work for anything else because I have to save any sick days that I have for a migraine.
Social, community, and civic roles	55	Ability to participate in social gatherings with friends or family, participate in community life, or civic events	I’m a volunteer [specifics redacted] here in the area where I live. I write letters to the elderly who have no one to write to them. So, I’m trying to do the things that I can do that can work with the migraine. I’d love to be more active. I’d love to be more out and engage with the public on causes that matter to me, but I realize that I’m limited by what I can do. I have missed functions, baby showers, weddings, due to migraines…Anything that’s enjoyable, you can’t do when you have a migraine above a 4 or a 5 on a scale of 1 to 10. You just can’t do it…can’t go to a soccer game, watch your kids play sports or something.
Interpersonal relations	38	Ability to form and maintain personal relations and engage in interpersonal interactions with non-family members or people outside the household	I’ve lost friendships because they don’t want to hear me complain, or they don’t want to be canceled on. I want to be able to enjoy myself and hang out with friends and everything…I also want to be—make sure I’m there—like my cognitive ability is also there. I don’t want to be there but then just taking up space, like I have nothing to contribute because I’m trying to get through a migraine.
Recreation and leisure	31	Ability to engage in recreational or leisure activities	I actually went to music school and I’m no longer able to play my French horn due to the pressure and the head and neck pain. Oh, activities, like if I wanted to go roller skating that day or I wanted to go exercise or ride my bike that day, get on the treadmill…Can’t go to the movies; you can’t go out to dinner. Anything that’s enjoyable, you can’t do when you have a migraine above a 4 or a 5 on a scale of 1 to 10. You just can’t do it. You’re not going to have fun.
Family relations	43	Impacts of migraine on family relationships or on one’s ability to participate in family relationships	You miss out on family time…Those things you don’t get—you don’t get that time back. I won’t be able to be with my children, who are grown—wanting me to do things with my grandkids…it takes away from them. And that makes life very, very depressing to me because my grandkids are my life.
Social support/isolation	22 (Study 2 only)	Ability to access social support—either from family, friends, community, colleagues, or a support group or organization; ability or inability to feel not alone or isolated	It’s like a family, another family, the whole migraine community. Everybody’s accepting and warm and you can talk about anything…You can say anything to them and they’re always there for you. But the migraines really isolated me. And I do struggle from depression, and it just magnified that a bunch. It was really brutal.
Intimate relations	17 (Study 2 only)	Ability to have intimate relationships, with or without sex	It has really destroyed relationships, both romantic sexual relationships as well as friendships, because it’s hard for people to handle, you know, my being sick so much…For example, I’ve gone from being married to divorced bachelor…it has become clear to me that, you know, that it really is more suitable for me to remain single and celibate. You know…because of my health - I’m not really in a position to where I could date or, you know, anything like that. It’s - it’s too challenging.
Care of other people or pets	28	Ability to provide care and fulfill any familial/household roles such as parenting, taking care of elders, taking care of pets, etc.	50% of the time, it’s even so bad that I can’t take the dogs out for a walk…I can’t function at the level I need to do to carry out those responsibilities. Like I said, I have six kids and my husband’s a disabled vet, so they all need me. So mama just pushes on through, takes the medicine and just keeps going. So it’s just kind of hard.
School	22	Ability to attend classes/days of school and complete required schoolwork, including full or part time and online or in person	I was trying to study engineering, and that was something that I absolutely loved. But my migraines didn’t like it because the heavy thinking and the math was so much all the time, it forced me to change my major into something liberal arts instead. Through high school, I had to go on independent study because they [migraine attacks] were so bad…[recently] I actually reenrolled back in school. So, now I’m trying to do school on the computer, which is another thing that migraines affect because it’s hard to look at the screen for that long.
Spiritual life	7	Ability to attend religious meetings or engage in routine religious activity at home (e.g., praying, fasting, preparing for holidays)	Well, one of my big things is going to church and helping out at church and stuff, and I haven’t been able to really go to church much or help out in the past several months, because I just - I can’t sit through a service for a whole hour.