du Toit Anina, Pretorius Chrisma
Stellenbosch University, Department of Psychology, Wilcocks Building, Victoria Street, Stellenbosch 7130, South Africa.
Stellenbosch University, Department of Psychology, Wilcocks Building, Victoria Street, Stellenbosch 7130, South Africa.
Seizure. 2017 Aug;50:43-52. doi: 10.1016/j.seizure.2017.06.004. Epub 2017 Jun 9.
Most studies conducted on the diagnosis and treatment of psychogenic nonepileptic seizures (PNES) have been performed in developed countries with developing countries, such as Namibia, receiving less attention. This study aimed to contribute to the aims of The International League against Epilepsy Psychogenic Nonepileptic Seizure Task Force by investigating the perceptions and frustrations of healthcare providers (HCPs) in Namibia regarding the diagnosis and treatment of psychogenic nonepileptic seizures.
Semi-structured interviews were conducted with fifteen HCPs from the private healthcare sector in Namibia. Thematic analysis was used to analyse the semi-structured interviews in order to identify themes and subthemes within the data.
Main themes centred on the areas of diagnosis, treatment, patients and awareness. It was found that HCPs' perceptions and frustrations were often related to the lack of knowledge and awareness regarding the disorder. Furthermore, the lack of access to specialized services and equipment contributed to HCPs' frustrations. Delays in the diagnosis of PNES added to HCPs' concerns regarding ineffective referral practices and the subsequent increase in healthcare costs. Although HCPs expressed the need for adequate training opportunities and increased awareness concerning the disorder, the lack of such opportunities and awareness campaigns were identified as possible problem areas.
It was evident from the findings that there are several gaps in how PNES are diagnosed and treated in Namibia. The unique challenges faced by a developing country such as Namibia were evident in some of the subthemes that highlighted the cultural differences in how PNES are conceptualized and treated.
大多数关于精神性非癫痫性发作（PNES）诊断和治疗的研究是在发达国家进行的，而纳米比亚等发展中国家受到的关注较少。本研究旨在通过调查纳米比亚医疗服务提供者（HCPs）对精神性非癫痫性发作诊断和治疗的看法及挫折感，为国际抗癫痫联盟精神性非癫痫性发作特别工作组的目标做出贡献。
对纳米比亚私立医疗部门的15名医疗服务提供者进行了半结构化访谈。采用主题分析法对这些半结构化访谈进行分析，以确定数据中的主题和子主题。
主要主题集中在诊断、治疗、患者和认知等方面。研究发现，医疗服务提供者的看法和挫折感往往与对该疾病缺乏了解和认知有关。此外，缺乏获得专业服务和设备的机会也加剧了医疗服务提供者的挫折感。精神性非癫痫性发作诊断的延迟增加了医疗服务提供者对无效转诊做法以及随后医疗成本增加的担忧。尽管医疗服务提供者表示需要有足够的培训机会并提高对该疾病的认知，但缺乏此类机会和宣传活动被确定为可能存在问题的领域。
从研究结果中可以明显看出，纳米比亚在精神性非癫痫性发作的诊断和治疗方面存在若干差距。纳米比亚这样的发展中国家所面临的独特挑战在一些子主题中很明显，这些子主题突出了在精神性非癫痫性发作的概念化和治疗方式上的文化差异。
