Sahaya Kinshuk, Dholakia Swapan A, Lardizabal David, Sahota Pradeep K
Department of Neurology, University of Michigan, Ann Arbor, MI 48109, USA.
Clin Neurol Neurosurg. 2012 Dec;114(10):1304-7. doi: 10.1016/j.clineuro.2012.03.047. Epub 2012 Apr 24.
Psychogenic non epileptic seizures (PNES) are challenging conditions to diagnose and manage. Previous workers have investigated the opinion of health care providers towards PNES; still several lacunae remain to be stressed. Amongst health care professionals, opinion of nurses has not been adequately explored. We attempted to identify areas which need more emphasis to provide optimal care to the patients.
We approached 417 health care providers (HCP; primary care, neurology and in-patient nurses) with a questionnaire regarding their opinion of PNES.
Total 115 respondents responded to our survey. We found one-thirds of respondent favoured "non-epileptic seizure" as the preferred diagnostic term. Although majority (61%) of responders felt that PNES were involuntary, 48% of nurses felt that PNES are 'fake' and patients have voluntary control over them. Neurologists and nurses expressed high level of confidence in managing patients of PNES. About 1/3rd (35%) of responders did not feel video EEG (vEEG) to be always required for the diagnosis of PNES. Only a minority (15%) of healthcare providers favor unrestricted driving by patients of PNES in setting of ongoing seizures.
Our findings highlight areas where more emphasis needs to be placed regarding PNES amongst HCPs. More emphasis needs to be placed on the involuntary nature of these episodes within the HCP community. It might be necessary to more strongly address the education of nurses and residents for this condition.
心因性非癫痫性发作（PNES）的诊断和管理具有挑战性。此前的研究人员已调查过医疗服务提供者对PNES的看法；但仍有几个空白有待强调。在医疗专业人员中，护士的看法尚未得到充分探讨。我们试图确定哪些领域需要更多关注，以便为患者提供最佳护理。
我们向417名医疗服务提供者（HCP；初级保健医生、神经科医生和住院护士）发放了一份关于他们对PNES看法的问卷。
共有115名受访者回复了我们的调查。我们发现三分之一的受访者倾向于使用“非癫痫性发作”作为首选诊断术语。尽管大多数（61%）受访者认为PNES是不由自主的，但48%的护士认为PNES是“假装的”，患者可以自主控制。神经科医生和护士对管理PNES患者表达了高度信心。约三分之一（35%）的受访者认为诊断PNES不一定总是需要视频脑电图（vEEG）。只有少数（15%）医疗服务提供者支持PNES患者在发作期间不受限制地驾驶。
我们的研究结果突出了在医疗服务提供者中需要更多关注PNES的领域。在医疗服务提供者群体中，需要更多地强调这些发作的不由自主性质。可能有必要更大力地加强对护士和住院医生关于这种疾病的教育。
