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患有运动和感觉功能神经性障碍的人的经历是怎样的?一项定性研究的系统综述与主题综合分析。

What are the experiences of people with motor and sensory functional neurological disorder? A systematic review and thematic synthesis of qualitative studies.

作者信息

Bailey Cate, Tamasauskas Arnas, Bradley-Westguard Abigail, Gilli Peter, Poole Norman, Edwards Mark J, Agrawal Niruj, Nicholson Timothy

机构信息

Neuropsychiatry Research and Education Group, Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK.

East London NHS Foundation Trust, London, UK.

出版信息

Disabil Rehabil. 2025 Jan;47(1):1-15. doi: 10.1080/09638288.2024.2333491. Epub 2024 Mar 29.

Abstract

PURPOSE

Functional neurological disorders are common, highly stigmatised and associated with significant disability. This review aimed to synthesise qualitative research exploring the experiences of people living with motor and/or sensory FND. Identifying their needs should inform service development, education for healthcare professionals and generate future research questions.

METHOD

Five databases were systematically searched (Medline, PsychInfo, Web of Science, Embase and Cinahl) in November 2022, updated in June 2023. Data from included papers was extracted by two authors and studies were critically appraised using the Critical Appraisal Skills Programme (CASP). Data was thematically analysed and synthesised.

RESULTS AND CONCLUSIONS

12 papers were included in the synthesis describing the views of 156 people with FND. The overarching theme was uncertainty; about what caused FND and how to live with it. Uncertainty was underpinned by four analytic themes; challenging healthcare interactions, loss of power and control, who or what is responsible and living with a visible disability and an invisible illness. Early and clear diagnosis, validation and support for living with FND should form part of multidisciplinary care. Co-produced service development, research agendas and education for clinicians, patients and the public would reduce stigma and improve the experiences of people with FND.

摘要

目的

功能性神经障碍很常见,备受污名化,且与严重残疾相关。本综述旨在综合定性研究,探讨运动性和/或感觉性功能性神经障碍患者的经历。明确他们的需求应为服务发展、医护人员教育提供信息,并产生未来的研究问题。

方法

2022年11月对五个数据库(Medline、PsychInfo、Web of Science、Embase和Cinahl)进行了系统检索,并于2023年6月更新。两名作者提取了纳入论文的数据,并使用批判性评估技能计划(CASP)对研究进行了严格评估。对数据进行了主题分析和综合。

结果与结论

该综述纳入了12篇论文,描述了156名功能性神经障碍患者的观点。总体主题是不确定性;包括功能性神经障碍的病因以及如何与之共处。不确定性由四个分析主题支撑;具有挑战性的医疗互动、失去权力和控制权、责任归属以及患有明显残疾和隐匿性疾病的生活。早期明确的诊断、对功能性神经障碍患者生活的验证和支持应成为多学科护理的一部分。共同制定的服务发展、研究议程以及针对临床医生、患者和公众的教育将减少污名化,改善功能性神经障碍患者的体验。

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