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Project title: The Morbidity associated with Painful Neuropathy in HIV-infected subjects Anti-Retroviral Therapies: An assessment of self-management stratergies

Objective: To establish the frequency of anti-retroviral treatment (ART)-related distal sensory polyneuropathy in a community-based clinic. To identify the self-management strategies these subjects are using to cope with their pain, and the possible impact on therapeutic management. Methods: A cross...

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Main Author: Ismail, Dr M
Other Authors: Heckmann, Jeannine
Format: Thesis
Language:English
Published: Department of Medicine 2014
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access_status_str Open Access
author Ismail, Dr M
author2 Heckmann, Jeannine
author_browse Heckmann, Jeannine
Ismail, Dr M
author_facet Heckmann, Jeannine
Ismail, Dr M
author_sort Ismail, Dr M
collection Thesis
description Objective: To establish the frequency of anti-retroviral treatment (ART)-related distal sensory polyneuropathy in a community-based clinic. To identify the self-management strategies these subjects are using to cope with their pain, and the possible impact on therapeutic management. Methods: A cross-sectional analysis was done of the patients attending the ART clinic at Woodstock Community Health Centre (CHC). During the three-month study period, 123 patients on anti-retroviral therapy were asked to answer the questionnaire and those who had painful feet, were then asked to complete questions about health- seeking behaviors. All participants were asked to complete questions about their health status and all were assessed with the Brief Peripheral Neuropathy Screen (BPNS). Based on the finding of the BPNS, subjects were divided into those with symptomatic distal sensory polyneuropathy (SDSP) and those without. SDSP was defined as the presence of any of the neuropathic symptoms in addition to one of the following; either reduced or absent ankle reflexes or abnormal vibration sense of 10 seconds at the great toes. Further data was obtained from patients by asking them to answer questions with regard to quality of life (QOL) as well depression. Results: Almost one third of patients were diagnosed with SDSP. Of those affected, 73% had significant pain ranging from moderate to severe intensity. Many of these patients were using self-management strategies, such as paracetamol (68%), while close to a third of patients were also using activities such as massaging feet, soaking or elevating feet. A significant proportion of patients with symptomatic neuropathy experienced a negative impact on the following QOL categories; mobility, usual activities, pain or discomfort and anxiety or depression. Further, those with SDSP were also more likely to be unemployed. Conclusions: Our results show that SDSP is a significant problem affecting patients' QOL and that those patients are not adequately treated for pain, hence seeking alternative management strategies. These strategies do not seem to adequately relieve pain and hence better pain management strategies need to be explored in primary care facilities.
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provenance_str_mv Harvested via OAI-PMH from UCTD — University of Cape Town Open Access Repository
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spelling oai:open.uct.ac.za:11427/3400 Project title: The Morbidity associated with Painful Neuropathy in HIV-infected subjects Anti-Retroviral Therapies: An assessment of self-management stratergies Ismail, Dr M Heckmann, Jeannine Objective: To establish the frequency of anti-retroviral treatment (ART)-related distal sensory polyneuropathy in a community-based clinic. To identify the self-management strategies these subjects are using to cope with their pain, and the possible impact on therapeutic management. Methods: A cross-sectional analysis was done of the patients attending the ART clinic at Woodstock Community Health Centre (CHC). During the three-month study period, 123 patients on anti-retroviral therapy were asked to answer the questionnaire and those who had painful feet, were then asked to complete questions about health- seeking behaviors. All participants were asked to complete questions about their health status and all were assessed with the Brief Peripheral Neuropathy Screen (BPNS). Based on the finding of the BPNS, subjects were divided into those with symptomatic distal sensory polyneuropathy (SDSP) and those without. SDSP was defined as the presence of any of the neuropathic symptoms in addition to one of the following; either reduced or absent ankle reflexes or abnormal vibration sense of 10 seconds at the great toes. Further data was obtained from patients by asking them to answer questions with regard to quality of life (QOL) as well depression. Results: Almost one third of patients were diagnosed with SDSP. Of those affected, 73% had significant pain ranging from moderate to severe intensity. Many of these patients were using self-management strategies, such as paracetamol (68%), while close to a third of patients were also using activities such as massaging feet, soaking or elevating feet. A significant proportion of patients with symptomatic neuropathy experienced a negative impact on the following QOL categories; mobility, usual activities, pain or discomfort and anxiety or depression. Further, those with SDSP were also more likely to be unemployed. Conclusions: Our results show that SDSP is a significant problem affecting patients' QOL and that those patients are not adequately treated for pain, hence seeking alternative management strategies. These strategies do not seem to adequately relieve pain and hence better pain management strategies need to be explored in primary care facilities. 2014-07-29T09:03:55Z 2014-07-29T09:03:55Z 2010 Master Thesis Masters http://hdl.handle.net/11427/3400 eng application/pdf Department of Medicine Faculty of Health Sciences University of Cape Town
spellingShingle Ismail, Dr M
Project title: The Morbidity associated with Painful Neuropathy in HIV-infected subjects Anti-Retroviral Therapies: An assessment of self-management stratergies
thesis_degree_str Master's
title Project title: The Morbidity associated with Painful Neuropathy in HIV-infected subjects Anti-Retroviral Therapies: An assessment of self-management stratergies
title_full Project title: The Morbidity associated with Painful Neuropathy in HIV-infected subjects Anti-Retroviral Therapies: An assessment of self-management stratergies
title_fullStr Project title: The Morbidity associated with Painful Neuropathy in HIV-infected subjects Anti-Retroviral Therapies: An assessment of self-management stratergies
title_full_unstemmed Project title: The Morbidity associated with Painful Neuropathy in HIV-infected subjects Anti-Retroviral Therapies: An assessment of self-management stratergies
title_short Project title: The Morbidity associated with Painful Neuropathy in HIV-infected subjects Anti-Retroviral Therapies: An assessment of self-management stratergies
title_sort project title the morbidity associated with painful neuropathy in hiv infected subjects anti retroviral therapies an assessment of self management stratergies
url http://hdl.handle.net/11427/3400
work_keys_str_mv AT ismaildrm projecttitlethemorbidityassociatedwithpainfulneuropathyinhivinfectedsubjectsantiretroviraltherapiesanassessmentofselfmanagementstratergies