Living with painful diabetic neuropathy: insights from focus groups into fears and coping strategies

Objective: Painful diabetic neuropathy (PDN) is known to negatively affect quality of life. Being physically active is a crucial part of successful diabetes self-management, but regimen adherence is often low. Coping strategies and fears have shown to be related to less physical activity (PA). The aim of the present study was to obtain more in-depth information on psychological risk factors leading to less PA in persons with PDN.

Design: Three semi-structured focus group interviews were conducted with a representative sample of persons with PDN (N?=?12). Data were transcribed verbatim and analysed using a hybrid method of thematic analyses and a grounded theory approach.

Main Outcome Measures: Fears and coping strategies related to PA in persons with PDN.

Results: Several specific fears were identified; fear of hypoglycaemia, fear of pain increase, fear of total exhaustion, fear of physical injury, fear of falling, fear of loss of identity, and fear of negative evaluation by others. To cope with these fears, avoidance, remaining active, cognitive distraction, and acceptance strategies were described.

Conclusion: In persons with PDN, diabetes-related fears and pain-related fears play a role in less engagement in PA, indicating the need for new methods for improving self-management in persons with PDN.     

ADOLESCENT DAUCHTER/MIDLIFE MOTHER DYAD A New Look at Separation and Self-Definition

The mother-daughter relationship is seen as complex, unique, and emotionally charged, with adolescence being the most difficult period for this dyad. Yet much of the literature has highlighted the struggle of adolescents, while underemphasizing that many of their mothers themselves are confronting their own developmental issues at this time. In this article, the developmental tasks and dyadic issues of adolescent daughters (aged 13–19) and their midlife mothers (aged 35–55) are examined from a psychodynamic perspective. The authors posit that both mother and daughter are experiencing a lifecycle crisis of separation and self-definition. Drawing from psychoanalytic and lifespan developmental literature as well as their own clinical experience, the authors propose that the current generation of mothers and daughters requires a new look at old models, parts of which may still be relevant and parts of which need to be revised or dropped. The issues of competition and rebellion as they relate to separation and self-definition are also addressed.