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 isoften an ill considered problem. It has a poor level of recognition from themedical establishment and from the general population. The devastating aspectsof diabetic foot disease including ulceration and gangrene and amputation arewell documented in medical literature. While the effects of PDN are routinelymanaged by podiatric services there is little research which explores PDN fromthe sufferer's perspective. This thesis uses sociological perspectives tounderstand how people make sense of the condition. It also examines howmedical consultations impact on their understanding.Twenty eight people who were referred to a specialist clinic with suspected PDNwere interviewed and their illness narratives collected. In addition the samplecompleted the Neuropathic Pain Scale. This was undertaken pre-consultationand two to four weeks post-consultation.This study shows that PDN creates uncertainty, disturbs and disrupts a person'sexpected life trajectory, causing a person to review who and what they are, theirselfhood. It creates tension in families as people struggle to tolerate new medicalregimens. The medical consultation provides a diagnosis but does little to helptheir understanding.There is a failure of medical services and society to recognise PDN. Thiscompounds the adverse feelings created. The use of a patient centredconsultation style and an increase in the availability of health education materialare crucial to rectify these feelings and ensure that greater attention is given toPDN in medical circles and beyond