O'Neal Mary A, Dworetzky Barbara A, Baslet Gaston
Department of Neurology, Brigham and Women's Hospital, United States.
Department of Psychiatry, Brigham and Women's Hospital, United States.
Epilepsy Behav Rep. 2021 Nov 14;16:100499. doi: 10.1016/j.ebr.2021.100499. eCollection 2021.
Patients with a functional neurological disorder can be difficult to engage in treatment. The reasons for this are complex and may be related to physician, patient and health care system issues. Providers contribute to difficulties in treatment engagement by giving confusing explanations for the patient symptoms, stigmatizing patients, and not allowing patients time to voice their questions and concerns. Patient factors include a lack of engagement after an explanation of the diagnosis, resistance to treatment, family/work dynamics and prior negative experiences with the health care system. The scarcity of providers skilled in the treatment of functional neurological disorder is yet another hurdle. This article will define these barriers and discuss good clinical practices to help improve outcomes by tackling those challenges and discuss why for many patients an integrated care team approach is needed.
功能性神经障碍患者可能难以参与治疗。其原因很复杂，可能与医生、患者及医疗保健系统问题有关。医疗服务提供者对患者症状给出令人困惑的解释、羞辱患者以及不给患者时间表达疑问和担忧，这些都导致治疗参与存在困难。患者因素包括在被告知诊断后缺乏参与度、对治疗的抵触、家庭/工作动态以及既往在医疗保健系统中的负面经历。缺乏治疗功能性神经障碍技能的医疗服务提供者也是另一个障碍。本文将界定这些障碍，并讨论通过应对这些挑战来改善治疗效果的良好临床实践，还将探讨为何对许多患者而言需要采用综合护理团队的方法。
