Fusunyan Mark, Medina Michel, Giambarberi Luciana, Bajestan Sepideh
Department of Psychiatry, Santa Clara Valley Medical Center, San Jose, Calif. (Fusunyan); Kaiser Permanente, Sacramento, Calif. (Medina); Department of Psychiatry and Behavioral Medicine, Wake Forest School of Medicine, Winston-Salem, N.C. (Giambarberi); Department of Psychiatry and Behavioral Sciences, Stanford University School of Medicine, Palo Alto, Calif. (Bajestan).
J Neuropsychiatry Clin Neurosci. 2024 Spring;36(2):166-171. doi: 10.1176/appi.neuropsych.20230060. Epub 2024 Jan 23.
Neuroscience-based patient education has become an evidence-based strategy for enhancing chronic pain treatment. Advances in understanding the neuroscience of functional neurological disorder (FND) may allow similar approaches to be developed and disseminated to clinicians, given the public health need for greater provider awareness and expertise around the condition. Accordingly, the authors developed an online video module for clinicians that delivers neuroscience-based psychoeducation for FND and assessed whether the intervention would be associated with changes in clinicians' perception of FND patients and knowledge about the condition. The online intervention consisted of a 20-minute video module, including an 8-minute scripted role-play that modeled neuroscience-informed diagnosis delivery. Pre- and postintervention questionnaires were embedded into the online module and included a self-assessment of FND-related perceptions and knowledge and a multiple-choice assessment of retention of the neuroscience-based content. Wilcoxon signed-rank tests and McNemar's tests were used for statistical analyses. Of the 103 individuals who submitted surveys, 40 participants provided a complete data set from before and after the intervention. Following the intervention, self-assessment items showed respondents had significantly greater comfort with diagnosis delivery and treatment options and decreased negative perception of FND patients. The percentage of correct responses on a multiple-choice assessment regarding the functional neuroanatomy of FND was significantly increased. In summary, the online neuroscience-based educational intervention was effective for increasing clinician knowledge about FND and comfort with diagnosis delivery and treatment options. Implementing web-based formats may be a viable and cost-effective approach to disseminating knowledge and basic clinical skills in the care of patients with FND.
基于神经科学的患者教育已成为增强慢性疼痛治疗效果的循证策略。鉴于公共卫生领域需要提高医疗服务提供者对功能性神经障碍（FND）的认识和专业知识，对FND神经科学理解的进展可能会促使类似方法得以开发并传播给临床医生。因此，作者为临床医生开发了一个在线视频模块，提供基于神经科学的FND心理教育，并评估该干预措施是否会与临床医生对FND患者的认知变化以及对该病症的了解相关联。在线干预包括一个20分钟的视频模块，其中有一个8分钟的脚本角色扮演，模拟了基于神经科学的诊断过程。干预前后的问卷被嵌入到在线模块中，包括对FND相关认知和知识的自我评估，以及对基于神经科学内容的记忆的多项选择评估。采用Wilcoxon符号秩检验和McNemar检验进行统计分析。在提交调查问卷的103人中，有40名参与者提供了干预前后的完整数据集。干预后，自我评估项目显示，受访者在进行诊断和选择治疗方案时明显更有信心，对FND患者的负面看法也有所减少。关于FND功能神经解剖学的多项选择评估中正确回答的百分比显著提高。总之，基于神经科学的在线教育干预有效地增加了临床医生对FND的了解，以及他们在进行诊断和选择治疗方案时的信心。采用网络形式可能是一种可行且具有成本效益的方法，用于在FND患者护理中传播知识和基本临床技能。
