Rambam Health Care Center, Neurology Department, Haifa, Israel.
Ministry of Education, Department of Special Education, Afula, Israel.
Arq Neuropsiquiatr. 2022 Nov;80(11):1097-1103. doi: 10.1055/s-0042-1758646. Epub 2022 Dec 28.
Psychogenic nonepileptic seizures (PNESs) are paroxysmal events that resemble epileptic seizures without concomitant changes in electroencephalograms (EEGs) or any other physiological cause. These seizures are one of the most common and dramatic conversion disorders. First responders treat many PNES patients with unnecessary emergency abortive medication and sometimes even intubate them. Several of our PNES patients have complained they have experienced harsh attitudes from health care practitioners (HCPs), especially during their stay in the emergency room (ER).
To assess the emotional attitude of HCPs toward PNES patients.
We handed a questionnaire containing 23 questions regarding PNES patients to HCPs from emergency medicine, internal medicine, and neurology disciplines. The questions dealt with three categories: diagnosis, management, and emotional attitudes.
Overall, 47 HCPs participated in this study: 11 ER, 18 internal medicine, and 18 neurology practitioners. The HCP from those disciplines showed high knowledge and good management practice of PNES patients. On the other hand, the HCPs agreed with most emotional attitude statements regarding PNES patients, reflecting a high percentage of negative emotional attitudes toward this group of patients. We did not find any correlation between negative emotional attitude and HCP department, profession, or seniority.
Although HCPs in our center perform good management practice regarding PNES patients, most reported a negative emotional attitude. This finding implies that what PNES patients feel regarding the harsh attitudes is also reflected by HCP views. Emotional attitudes towards PNES patients may not depend solely on the level of knowledge of the HCPs.
心因性非癫痫性发作（PNES）是一种类似于癫痫发作的阵发性事件，但脑电图（EEG）或任何其他生理原因没有伴随变化。这些发作是最常见和最戏剧性的转换障碍之一。急救人员经常对许多 PNES 患者使用不必要的紧急中止药物治疗，有时甚至对他们进行插管。我们的一些 PNES 患者抱怨他们曾受到医疗保健从业者（HCPs）的恶劣态度对待，尤其是在他们在急诊室（ER）逗留期间。
评估 HCPs 对 PNES 患者的情绪态度。
我们向来自急诊医学、内科和神经病学领域的 HCPs 分发了一份包含 23 个关于 PNES 患者问题的问卷。这些问题涉及三个类别：诊断、管理和情绪态度。
共有 47 名 HCP 参与了这项研究：11 名急诊医生、18 名内科医生和 18 名神经病学医生。这些学科的 HCP 对 PNES 患者表现出了较高的知识水平和良好的管理实践。另一方面，HCPs 对大多数关于 PNES 患者的情绪态度陈述表示赞同，反映出对这组患者存在较高比例的负面情绪态度。我们没有发现负面情绪态度与 HCP 科室、专业或资历之间存在任何相关性。
尽管我们中心的 HCPs 对 PNES 患者的管理实践表现良好，但大多数人报告了负面的情绪态度。这一发现表明，PNES 患者对恶劣态度的感受也反映了 HCP 的观点。对 PNES 患者的情绪态度可能不仅仅取决于 HCP 的知识水平。
