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Living with painful diabetic neuropathy: insights from focus groups into fears and coping strategies
Authors:Iris M Kanera  Joop M Ruijgrok  Marielle E J B Goossens  Jeroen R de Jong  Jeanine A Verbunt
Institution:1. Research Centre for Nutrition, Lifestyle, and Exercise, Faculty of Health, Zuyd University of Applied Sciences, Heerlen, The Netherlands;2. Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands;3. Department of Rehabilitation Medicine, Maastricht University, Maastricht, The Netherlands;4. Neurorehabilitation Centre, Klinik Bethesda Tschugg, Tschugg, Switzerland;5. Department of Rehabilitation Medicine, Maastricht University Medical Centre (MUMC+), Maastricht, The Netherlands;6. Adelante Centre of Expertise in Rehabilitation and Audiology, Hoensbroek, The Netherlands
Abstract: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.

Keywords:Diabetes  neuropathic pain  fear  coping  self-management  diabetes self-care
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