title: Burden of Illness of Diabetic Peripheral Neuropathic Pain: A Qualitative Study.
abstract: BACKGROUND
  Diabetic peripheral neuropathy (DPN) is the result of nerve damage in the toes, feet, or hands, causing loss of feeling or pain for up to 50% of patients. The purpose of this qualitative study was to assess the burden and impact of DPN pain (DPNP) symptoms on patient's functioning and well-being.
  
  
  METHODS
  Four focus groups and 47 telephone interviews were conducted to understand the experience and impacts of DPNP from the patient's perspective. All participants were over the age of 18 years, read/spoke English, had a documented diagnosis of DPNP with symptoms for 6 months and a minimum 12-month history of diabetes mellitus, and had a daily pain rating of at least 4 on an 11-point numerical rating scale. Interview transcripts were analyzed thematically based on modified grounded theory principles.
  
  
  RESULTS
  There were 70 respondents--48 (68.6%) males and 22 (31.4%) females. The mean age was 54.0 years (range 26-70), and nearly all respondents had type 2 diabetes (87%). Analysis identified four major areas of impact; DPNP patients reported difficulties with: (1) physical function, i.e. walking, exercise, energy, standing, balance, bending, and mobility; (2) daily life, i.e. productivity, recreational activities, work, enjoyment, focus, and chores; (3) social/psychological, i.e. anxiety, friends/family, irritability, depression, and fear; and (4) sleep, i.e. sleep, falling asleep, waking in the night, returning to sleep, and not feeling rested upon awakening.
  
  
  CONCLUSIONS
  DPNP is a significant complication of diabetes with multiple impacts for patient functioning and well-being, which increase the burden of disease.
authors.affiliation: The Brod Group, 219 Julia Avenue, Mill Valley, CA, 94941, USA, mbrod@thebrodgroup.net.
authors.forename: Meryl
authors.initials: M
authors.lastname: Brod
authors.forename: Betsy
authors.initials: B
authors.lastname: Pohlman
authors.forename: Steven I
authors.initials: SI
authors.lastname: Blum
authors.forename: Abhilasha
authors.initials: A
authors.lastname: Ramasamy
authors.forename: Robyn
authors.initials: R
authors.lastname: Carson
mesh_terms: D000203:Activities of Daily Living; D000328:Adult; D000368:Aged; D003929:Diabetic Neuropathies / Q000503:physiopathology* / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D051346:Mobility Limitation; D036301:Qualitative Research; D011788:Quality of Life; D012890:Sleep; D058992:Social Participation