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Cevik AB, Olgun N. The Predictors of Painful Diabetic Neuropathy and Its Effect on Quality of Life. Pain Manag Nurs 2021; 23:345-352. [PMID: 34030993 DOI: 10.1016/j.pmn.2021.04.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 03/22/2021] [Accepted: 04/03/2021] [Indexed: 11/30/2022]
Abstract
BACKGROUND Knowing the prevalence and predictors of neuropathic pain and its impacts on the quality of life (QoL) using measurement tools is important for good diabetes management. In Turkish society, neuropathic pain, its predictors and its impact on the quality of life of diabetics are not considered enough. OBJECTIVES This study examined the prevalence and predictors of neuropathic pain and its impacts on the quality of life in diabetics in Rize Province, Turkey. DESIGN This study was designed as a cross-sectional, correlational study. SETTING Data collected through face-to-face interviews. The sample size was determined using the formula [n= N t2pq / d2 (N-1) + t2pq]. PARTICIPANT The sample of the study consisted of 122 people with diabetes who visited the diabetes outpatient clinic of the hospital. METHODS A Personal Information Form, Douleur Neuropathique en 4 questions (DN4), and Leeds Assessment of Neuropathic Symptoms and Signs (LANSS) were used to collect data. Pain intensity was measured using Visual Analogue Scale (VAS) RESULTS: The prevalence of the diagnosed painful diabetic polyneuropathy (PDPN) was found to be 22.9%. On the other hand, the prevalence of the undiagnosed PDPN was found to be 44.3% according to DN4 and 27.9% according to LANSS. The VAS pain score was determined as 1.99±1.20 (range: 1-5). In the people with PDPN, nephropathy was seen 4.514 times more frequently according to DN4 and 7.217 times more frequently according to LANSS. Painful diabetic peripheral neuropathy had negative effects on all dimensions of QoL except for social function and mental health (p <0.05). CONCLUSIONS It is important for nurses to determine the prevalence and predictive factors of PDPN in their region and to evaluate the effect of pain on the quality of life of diabetics. Nurses should attempt to increase the quality of life of people with diabetes by reducing the predictors affecting pain.
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Affiliation(s)
- Ayfer Bayindir Cevik
- Bartın University, Faculty of Health Sciences, Ağdacı Mahallesi, Ağdacı Köyü Yolu, Bartın, Turkey.
| | - Nermin Olgun
- Hasan Kalyoncu University, Yeşilkent, Gaziantep, Turkey
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Benavidez GA, Ylitalo KR, Lanning B, Asare M, Meyer A, Griggs JO. Peripheral neuropathy and depressive symptoms: examining the association in a primary health care setting among persons with and without diabetes mellitus. Qual Life Res 2020; 29:3297-3304. [PMID: 32651803 DOI: 10.1007/s11136-020-02579-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/03/2020] [Indexed: 11/24/2022]
Abstract
PURPOSE The purpose of this study was to measure the association between peripheral neuropathy symptoms and depressive symptoms among a sample of patients with and without diabetes mellitus (DM). METHODS Patients were administered the 15-item Michigan Neuropathy Screening Instrument (MNSI) and the patient health questionnaire depression scale (PHQ-8). Patients with an MNSI score ≥ 4 were categorized as having PN and patients with a PHQ-8 score ≥ 10 were considered to have current depression. Log-binomial regression was used to analyze the relationship between PN and depressive symptoms. RESULTS 406 patients were included in the final analysis. There were no statistically significant differences by diabetes status in PN symptoms (Diabetes = 61.8%; No diabetes = 55.4%; p = .20) or in depression status (Diabetes = 37.6%; No diabetes = 36.6%; p = .83). After adjustment for covariates, PN was associated with depression (aRR = 4.46; 95% CI 2.91,6.85) independent of diabetes status. CONCLUSIONS PN symptoms may be common among aging persons even in the absence of DM. Past literature and our study demonstrate that PN and depression are closely associated. More work is needed to understand the etiology and potential utility of intervention for depression symptoms among patients with neuropathy.
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Affiliation(s)
- Gabriel A Benavidez
- Department of Public Health, Baylor University, One Bear Place #97343, Waco, TX, 76798, USA.
| | - Kelly R Ylitalo
- Department of Public Health, Baylor University, One Bear Place #97343, Waco, TX, 76798, USA
| | - Beth Lanning
- Department of Public Health, Baylor University, One Bear Place #97343, Waco, TX, 76798, USA
| | - Matt Asare
- Department of Public Health, Baylor University, One Bear Place #97343, Waco, TX, 76798, USA
| | - Andrew Meyer
- Department of Health, Human Performance, and Recreation, Baylor University, One Bear Place #97313, Waco, TX, 76798, USA
| | - Jackson O Griggs
- Waco Family Health Center, 1600 Providence Dr, Waco, TX, 76707, USA
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Timar R, Velea I, Timar B, Lungeanu D, Oancea C, Roman D, Mazilu O. Factors influencing the quality of life perception in patients with type 2 diabetes mellitus. Patient Prefer Adherence 2016; 10:2471-2477. [PMID: 28003741 PMCID: PMC5158177 DOI: 10.2147/ppa.s124858] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022] Open
Abstract
PURPOSE To evaluate the impact of several factors on the patient's perception on quality of life in a group of patients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS In this cross-sectional study, 198 patients with T2DM were enrolled according to a consecutive-case population-based study design. In all participants, the perception on the quality of life was measured using the quality of life index - diabetes version III proposed by Ferrans and Powers. We evaluated the impact of several anthropometric and diabetes-related (ie, diabetes history and quality of glycemic control) factors on the patient's perception on the quality of life. RESULTS The presence of diabetes complications was associated with a decreased quality of life: retinopathy (1 vs 5 points; P<0.001), chronic kidney disease (-1 vs 5 points; P<0.001), and neuropathy (-1 vs 5 points; P<0.001). A significant reverse correlation was found between the patient's quality of life and depression's severity (Spearman's r=-0.345; P<0.001) and body mass index (Spearman's r=-0.158; P=0.026). A positive association between the quality of life and the quality of diabetes-related self-care activities was found (Spearman's r=0.338; P<0.001). No significant association was found between the patient's quality of life and the quality of glycemic control, diabetes duration, age, gender, or smoking status. CONCLUSION To improve the patient's quality of life, special care should be given to the modifiable diabetes-related factors: the prevention and treatment of diabetes complications, treatment of depression, and weight loss in obese and overweight patients.
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Affiliation(s)
| | | | | | | | | | - Deiana Roman
- Faculty of General Medicine, “Victor Babes” University of Medicine and Pharmacy
| | - Octavian Mazilu
- First Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
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Castelnuovo G, Giusti EM, Manzoni GM, Saviola D, Gatti A, Gabrielli S, Lacerenza M, Pietrabissa G, Cattivelli R, Spatola CAM, Corti S, Novelli M, Villa V, Cottini A, Lai C, Pagnini F, Castelli L, Tavola M, Torta R, Arreghini M, Zanini L, Brunani A, Capodaglio P, D'Aniello GE, Scarpina F, Brioschi A, Priano L, Mauro A, Riva G, Repetto C, Regalia C, Molinari E, Notaro P, Paolucci S, Sandrini G, Simpson SG, Wiederhold B, Tamburin S. Psychological Considerations in the Assessment and Treatment of Pain in Neurorehabilitation and Psychological Factors Predictive of Therapeutic Response: Evidence and Recommendations from the Italian Consensus Conference on Pain in Neurorehabilitation. Front Psychol 2016; 7:468. [PMID: 27148104 PMCID: PMC4835496 DOI: 10.3389/fpsyg.2016.00468] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/19/2016] [Accepted: 03/16/2016] [Indexed: 12/13/2022] Open
Abstract
Background: In order to provide effective care to patients suffering from chronic pain secondary to neurological diseases, health professionals must appraise the role of the psychosocial factors in the genesis and maintenance of this condition whilst considering how emotions and cognitions influence the course of treatment. Furthermore, it is important not only to recognize the psychological reactions to pain that are common to the various conditions, but also to evaluate how these syndromes differ with regards to the psychological factors that may be involved. As an extensive evaluation of these factors is still lacking, the Italian Consensus Conference on Pain in Neurorehabilitation (ICCPN) aimed to collate the evidence available across these topics. Objectives: To determine the psychological factors which are associated with or predictive of pain secondary to neurological conditions and to assess the influence of these aspects on the outcome of neurorehabilitation. Methods: Two reviews were performed. In the first, a PUBMED search of the studies assessing the association between psychological factors and pain or the predictive value of these aspects with respect to chronic pain was conducted. The included papers were then rated with regards to their methodological quality and recommendations were made accordingly. In the second study, the same methodology was used to collect the available evidence on the predictive role of psychological factors on the therapeutic response to pain treatments in the setting of neurorehabilitation. Results: The first literature search identified 1170 results and the final database included 189 articles. Factors such as depression, anxiety, pain catastrophizing, coping strategies, and cognitive functions were found to be associated with pain across the various conditions. However, there are differences between chronic musculoskeletal pain, migraine, neuropathy, and conditions associated with complex disability with regards to the psychological aspects that are involved. The second PUBMED search yielded 252 studies, which were all evaluated. Anxiety, depression, pain catastrophizing, coping strategies, and pain beliefs were found to be associated to different degrees with the outcomes of multidisciplinary programs, surgery, physical therapies, and psychological interventions. Finally, sense of presence was found to be related to the effectiveness of virtual reality as a distraction tool. Conclusions: Several psychological factors are associated with pain secondary to neurological conditions and should be acknowledged and addressed in order to effectively treat this condition. These factors also predict the therapeutic response to the neurorehabilitative interventions.
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Affiliation(s)
- Gianluca Castelnuovo
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | | | - Gian Mauro Manzoni
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Faculty of Psychology, eCampus UniversityNovedrate, Italy
| | - Donatella Saviola
- Cardinal Ferrari Rehabilitation Center, Santo Stefano Rehabilitation Istitute Fontanellato, Italy
| | | | | | | | - Giada Pietrabissa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | - Roberto Cattivelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Chiara A M Spatola
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | - Stefania Corti
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Margherita Novelli
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Valentina Villa
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | | | - Carlo Lai
- Department of Dynamic and Clinical Psychology, Sapienza University of Rome Rome, Italy
| | - Francesco Pagnini
- Department of Psychology, Catholic University of MilanMilan, Italy; Department of Psychology, Harvard UniversityCambridge, MA, USA
| | - Lorys Castelli
- Department of Psychology, University of Turin Turin, Italy
| | | | - Riccardo Torta
- Department of Neuroscience "Rita Levi Montalcini", University of Turin Turin, Italy
| | - Marco Arreghini
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Loredana Zanini
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Amelia Brunani
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Paolo Capodaglio
- Rehabilitation Unit, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Guido E D'Aniello
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Federica Scarpina
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Neuroscience "Rita Levi Montalcini", University of TurinTurin, Italy
| | - Andrea Brioschi
- Department of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe Hospital Verbania, Italy
| | - Lorenzo Priano
- Department of Neuroscience "Rita Levi Montalcini", University of TurinTurin, Italy; Department of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Alessandro Mauro
- Department of Neuroscience "Rita Levi Montalcini", University of TurinTurin, Italy; Department of Neurology and Neurorehabilitation, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy
| | - Giuseppe Riva
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | - Claudia Repetto
- Department of Psychology, Catholic University of Milan Milan, Italy
| | - Camillo Regalia
- Department of Psychology, Catholic University of Milan Milan, Italy
| | - Enrico Molinari
- Psychology Research Laboratory, Istituto Auxologico Italiano IRCCS, San Giuseppe HospitalVerbania, Italy; Department of Psychology, Catholic University of MilanMilan, Italy
| | - Paolo Notaro
- "Pain Center II Level - Department of Surgery" - ASST Grande Ospedale Metropolitano Niguarda Milano, Italy
| | | | - Giorgio Sandrini
- Department of Brain and Behavioral Sciences, C. Mondino National Neurological Institute, University of Pavia Pavia, Italy
| | - Susan G Simpson
- School of Psychology, Social Work and Social Policy, University of South Australia Magill, SA, Australia
| | | | - Stefano Tamburin
- Department of Neurological and Movement Sciences, University of Verona Verona, Italy
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Timar B, Timar R, Schiller A, Oancea C, Roman D, Vlad M, Balinisteanu B, Mazilu O. Impact of neuropathy on the adherence to diabetes-related self-care activities: a cross-sectional study. Patient Prefer Adherence 2016; 10:1169-75. [PMID: 27445464 PMCID: PMC4936822 DOI: 10.2147/ppa.s107621] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
PURPOSE The purpose of this study was to evaluate the impact of the presence and severity of neuropathy and depression on the patient's adherence to diabetes-related self-care activities (DRSCA) in a cohort of patients with type 2 diabetes mellitus (T2DM). PATIENTS AND METHODS In this cross-sectional, noninterventional study, 198 patients with T2DM were enrolled according to a population-based, consecutive-case enrollment principle. In all patients, the adherence to DRSCA was evaluated using the Summary of Diabetes Self-Care Activities (SDSCA) questionnaire; a higher SDSCA score is associated with a better adherence. The presence and severity of neuropathy was assessed using the Michigan Neuropathy Screening Instrument (MNSI) and the severity of depression using the Patient Health Questionnaire-9 (PHQ-9). RESULTS The presence of neuropathy was associated with a decreased SDSCA score (26 points vs 37 points; P<0.001), an increased severe depression prevalence (24.7% vs 4.3%; P<0.001), and an increased PHQ-9 score (12 points vs 7 points; P<0.001). The MNSI score was reverse correlated with SDSCA score (r=-0.527; P<0.001) and positively correlated with PHQ-9 score (r=0.495; P<0.001). The reverse correlation between MNSI score and SDSCA score was present for all the subcomponents of SDSCA questionnaire (diet, exercise, glycemic monitoring, and foot care). CONCLUSION The presence of neuropathy is associated with decreases in the quality of adherence to DRSCA in patients with T2DM and with increases in the symptomatology of depression. The significant, negative association between the severity of T2DM and the quality of disease self-management points to a possible loop-type relationship between these two components, being possible a reciprocal augmentation with negative consequences on the global management of the disease.
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Affiliation(s)
| | - Romulus Timar
- Second Department of Internal Medicine
- Correspondence: Romulus Timar, Second Department of Internal Medicine, “Victor Babes” University of Medicine and Pharmacy, 2 Eftimie Murgu, 300041 Timisoara, Romania, Tel +40 7 4152 8093, Fax +40 256 46 2856, Email
| | | | | | | | | | | | - Octavian Mazilu
- First Department of Surgery, “Victor Babes” University of Medicine and Pharmacy, Timisoara, Romania
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Adeghate E, Fehér E, Kalász H. Evaluating the Phase II drugs currently under investigation for diabetic neuropathy. Expert Opin Investig Drugs 2014; 24:1-15. [PMID: 25171371 DOI: 10.1517/13543784.2014.954033] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
Abstract
Introduction: The worldwide number of patients suffering from diabetes mellitus (DM) is projected to approach 552 million by the year 2030. As diabetic neuropathy (DN) is present in 8% of new diabetic patients at the time of diagnosis and occurs in ∼ 50% of all patients with established DM, the number of patients who will develop painful DN will also increase. The suboptimal efficacies of currently approved drugs have prompted investigators to develop new therapeutic agents for the management of painful DN. Areas covered: In this review, the authors present and elucidate the current status of drugs under investigation for the treatment of painful DN. A short synopsis of currently approved drugs is also given. Literature information and data analysis were retrieved from PubMed, the American Diabetes and Neurological Associations Websites and ClinicalTrials.gov. The keywords used in the search included: DM, DN, painful diabetic neuropathy. Expert opinion: In addition to treating the pain associated with DN, the actual causes of the disease should also be targeted for improved management. It is hoped that drugs which improve vascular blood flow, induce neural regeneration, reduce hyperglycemia, oxidative stress and inflammation can be more effective for the overall treatment of painful DN.
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Affiliation(s)
- Ernest Adeghate
- United Arab Emirates University, College of Medicine and Health Sciences, Department of Anatomy , P.O Box 17666, Al Ain , UAE +971 3 7672033 ;
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