Tuesday 23 August 2011

Psychosocial Considerations and Quality of Life Issues in Peripheral Neuropathy

It's something your doctor may not have time to address but unless you have help from elsewhere, the psychological effects of neuropathy are easily underestimated, whilst contributing to making your life a misery. This article from Medifocus Health (see link below) shows what happens to many neuropathy patients, sometimes without them realising it themselves. It's very important to be aware of how quickly your mental state can change when you're continually under stress from ill health. If you're also HIV positive, these problems can become exaggerated and friends and family become more important than ever!


Psychosocial Considerations and Quality of Life Issues in Peripheral Neuropathy

"Quality of life" is a measure of how well patients adjust to their condition. It measures many factors related to living with a medical condition, including:
•Physical and material well-being
•Social relationships with other people (e.g., spouse, siblings, or friends)
•Social activities (e.g., helping others, getting together with other individuals or groups, community/religious involvement)
•Personal fulfillment (e.g., career, creativity, pursuit of intellectual interests)
•Recreational activities (e.g., sports or relaxation)
•Health status (perceived and actual)

A significant aspect of quality of life and ability to function daily is related to how individuals with peripheral neuropathy perceive themselves and regard their situation. Physical well-being has the greatest influence on a person's perceived health status and on most other measures evaluated in quality of life test scales.

Chronic neuropathic pain can be very debilitating and can affect several dimension of daily life as reflected in lower scores of quality of life scales including:
•Psychological health (e.g., depression, anxiety)
•Work-related problems (e.g., reduced levels of productivity, absenteeism)
•Sleep disturbances
•Feelings of isolation
•Sense of disappointment that expectations of recovery are not being met

Peripheral neuropathy affects a wide range of people and its impact on quality of life is closely related to the severity of this interference in daily life. In some people it is very debilitating and chronic, while others may be affected only intermittently with varying degrees of discomfort ranging from mild to severe. Pain management programs play an important role in teaching individuals how to live with their condition. These programs focus on pain control, as well as social and physical functioning, and emotional health. Another benefit of pain management programs is that they usually consist of several types of professionals, including psychologists or psychiatrists who can help monitor emotional status and try to prevent secondary conditions such as depression and withdrawal from society in individuals with peripheral neuropathy.

Depression is not uncommon in persons with peripheral neuropathy due to the chronic aspect of the pain, loss of function, emotional burden, and reduced quality of life. Some of the medications used to treat peripheral neuropathy are actually antidepressants and may help to control depression as well. However, it is very important that patients share feelings of depression with their health care providers so that they can be addressed appropriately. Support groups are helpful for many persons in coping with the pain and discomfort and its impact on daily life.

Response to medications is extremely variable and many patients try numerous types and doses of medications before finding one that brings some measure of relief. Some doctors and patients find that keeping a daily pain diary is a useful tool to monitor responses to medications and therapies so that changes or adjustments to patients' pain management programs can be implemented as needed. Response to monotherapy (one drug) is estimated to bring a 30-50% reduction in pain, at best. Multi-drug therapies that target different parts of the nerve pathways may be more effective. Although there are no clinical trials to date regarding multi-drug treatment of peripheral neuropathy, this strategy is often practiced by physicians.

http://www.medifocushealth.com/NR021/Understanding-Peripheral-Neuropathy_Psychosocial-Considerations-and-Quality-of-Life-Issues-in-Peripheral-Neuropathy.php

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