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The behavioral therapies that could directly target the fears (fear of falling) faced by PDN patients should be designed to improve their physiological well-being.
Diabetic neuropathy is
counted among most prevalent long-term disorder. It is the debilitating
consequence of diabetes, which is characterized by diffuse damage to the
peripheral nerve fibers. This painful diabetic neuropathy (PDN) has a
tremendous negative impact on psychosocial functioning, which is expressed by
increased levels of depression and anxiety. However, how these pain-related
fears affect patient's health is yet to be probed.
Therefore, scientists
conducted a questionnaire-based cross-sectional study specifying diabetes and
its pain-related fears. The evaluation was done among 154 PDN patients with
mean age of 65.7 ± 6.6 years. The correlation analysis was performed for age,
gender, pain duration, pain intensity and insulin treatment to determine the
relation of kinesiophobia, fear of pain, hypoglycaemia, fear of falling, fear
of negative evaluation, fear of fatigue, quality of life and disability. Every
factor was measured differently. The kinesiophobia by TSK (Tampa Scale of
Kinesiophobia), fear of pain by PASS-20 (Pain Anxiety Symptom Scale),
hypoglycaemia by HFS (Hypoglycaemia Fear Survey), fear of falling by FES-I
(Falls Efficacy Scale-I), fear of negative evaluation by BFNE (Brief Fear of
Negative Evaluation Scale), fear of fatigue by TSF (Tampa Scale of Fatigue),
quality of life by Norfolk Quality of
Life Questionnaire, Diabetic Neuropathy Version (QoL-DN) and disability by
Pain Disability Index (PDI).
The univariate analyses
were done in which all the fears were independently related with QOL-DN and PDI
(p<0.001). Further, the linear
regression models of all concern and confounders demonstrated that QOL-DN was
significantly associated with pain duration, pain intensity and FES-I. The PDI
showed a relation with male gender, pain intensity and FES-I. However, after
controlling for confounders, duration of pain, fear of falling and pain
intensity levels showed a negative relation with QoL. Although, male gender,
fear of falling and pain intensity showed a positive relationship with
disability.
Therefore, it is clear from
the study that PDN patients indeed suffer from various fears. The knowledge
about these fears and its association with PDN is very beneficial. It enables
scientists to identify potential targets for behavioral interventions and
design a treatment strategy. Also, it helps to improve physical and
psycho-social well-being in PDN patients.
Eur J Pain. 2017 Jun 27. doi: 10
Anxiety affects disability and quality of life in patients with painful diabetic neuropathy
Geelen CC et al.
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