Neurophysiology Department, University College Hospitals London NHS Foundation Trust, London, UK.
Audiology Department, College of Health and Life Sciences, Aston University, Birmingham B47ET, UK.
Epilepsy Behav. 2022 Feb;127:108501. doi: 10.1016/j.yebeh.2021.108501. Epub 2022 Jan 8.
To explore the perspectives of clinical physiologists on working with patients with nonepileptic attack disorder (NEAD). Nonepileptic attack disorder is a medically unexplained symptom frequently encountered by clinical physiologists in the field of neurophysiology. Studies in healthcare professionals show that they often find patients with medically unexplained symptoms challenging, uncomfortable, and frustrating to interact with. Clinical physiologists spend a substantial amount of time with patients and are key to the assessment of the condition. It is not known how physiologists experience working with patients with NEAD.
Semi-structured interviews were conducted with clinical physiologists who frequently work with these patients. Interviews were recorded, transcribed, and analyzed according to grounded theory methodology.
Twelve participants including current trainees and qualified clinical physiologists working in neurophysiology were interviewed for the study. Participants described the experience of working with people with NEAD as anxiety provoking and unpredictable. The sources of this anxiety were the nature of the psychological aspects of the condition, the need to preserve professional boundaries and a lack of preparedness to manage conversations about distress or the psychological factors impacting the NEAD.
There is a risk that patient care is compromised by the lack of preparation and skills training of physiologists.
Physiologists need further training in counseling skills to increase tolerance to emotionally laden content in patient accounts and knowledge of suitable referral routes.
探讨临床生理学家在与非癫痫性发作障碍（NEAD）患者合作方面的观点。非癫痫性发作障碍是神经生理学领域的临床生理学家经常遇到的一种无法用医学解释的症状。医疗保健专业人员的研究表明，他们经常发现患有无法用医学解释的症状的患者具有挑战性、不适和令人沮丧，难以与之互动。临床生理学家与患者相处的时间相当长，是评估病情的关键。目前尚不清楚生理学家与 NEAD 患者合作的体验如何。
对经常与这些患者合作的临床生理学家进行了半结构化访谈。根据扎根理论方法对访谈进行了记录、转录和分析。
本研究共对 12 名参与者进行了访谈，包括目前的受训者和在神经生理学领域工作的合格临床生理学家。参与者将与 NEAD 患者合作的经历描述为令人焦虑和不可预测的。这种焦虑的来源是病情的心理方面的性质、需要维护专业界限以及缺乏处理关于痛苦或影响 NEAD 的心理因素的谈话的准备。
由于生理学家缺乏准备和技能培训，可能会影响患者的护理。
生理学家需要进一步接受咨询技巧培训，以提高对患者描述中情感内容的容忍度，并了解合适的转诊途径。
