The patient's experience of painful diabetic neuropathy : an empirical study

This study explores the experience of painful diabetic neuropathy (PDN). Although PDN has a prevalence of a third of the general diabetes population it is often an ill considered problem. It has a poor level of recognition from the medical establishment and from the general population. The devastating aspects of diabetic foot disease including ulceration and gangrene and amputation are well documented in medical literature. While the effects of PDN are routinely managed by podiatric services there is little research which explores PDN from the sufferer's perspective. This thesis uses sociological perspectives to understand how people make sense of the condition. It also examines how medical consultations impact on their understanding. Twenty eight people who were referred to a specialist clinic with suspected PDN were interviewed and their illness narratives collected. In addition the sample completed the Neuropathic Pain Scale. This was undertaken pre-consultation and two to four weeks post-consultation. This study shows that PDN creates uncertainty, disturbs and disrupts a person's expected life trajectory, causing a person to review who and what they are, their selfhood. It creates tension in families as people struggle to tolerate new medical regimens. The medical consultation provides a diagnosis but does little to help their understanding. There is a failure of medical services and society to recognise PDN. This compounds the adverse feelings created. The use of a patient centred consultation style and an increase in the availability of health education material are crucial to rectify these feelings and ensure that greater attention is given to PDN in medical circles and beyond