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揭示神经恐惧症:探索全球影响医学生、住院医师和非神经科医生的因素及其对神经科护理的影响——一项系统综述和荟萃分析。

Unveiling neurophobia: exploring factors influencing medical students, residents and non-neurologist physicians globally and its implications on neurology care - a systematic review and meta-analysis.

作者信息

AlZahrani Abdulrahman A, AlQahtani Bashaier G, Bayazeed Mawadda A, Mahfouz Mohammad Eid

机构信息

Emergency Department, KFMC, Riyadh, Saudi Arabia.

Neurology, PSMMC, Riyadh, Saudi Arabia.

出版信息

BMJ Neurol Open. 2025 May 21;7(1):e001009. doi: 10.1136/bmjno-2024-001009. eCollection 2025.

Abstract

BACKGROUND

Neurophobia, the fear of neurology, is a recognised global challenge in medical education and practice. This systematic review and meta-analysis aimed to quantify the prevalence of neurophobia among medical students, residents and non-neurologist physicians, identify contributing factors (including lack of basic science/clinical integration) and explore its implications for neurology care.

METHODS

We systematically searched PubMed, Scopus and Google Scholar for studies published between 2000 and 2024 reporting on neurophobia. Two independent reviewers screened the studies, extracted data and assessed their quality using the Newcastle-Ottawa Scale. A random effects meta-analysis was performed to estimate the pooled prevalence of neurophobia. Heterogeneity and publication bias were tested statistically.

RESULTS

Of the initial 1245 studies, 32 met the inclusion criteria. The pooled prevalence of neurophobia was 47.2% (95% CI: 39.8% to 54.6%), with significant heterogeneity (I²=98.7%, p<0.001). Subgroup analysis revealed a higher prevalence among medical students (52.3%, 95% CI: 44.1% to 60.5%) than residents and physicians (41.9%, 95% CI: 33.7% to 50.1%). Key contributing factors included the perceived complexity of neurology (OR: 3.2, 95% CI: 2.7 to 3.8) and inadequate exposure during training (OR: 2.8, 95% CI: 2.3 to 3.3). Individuals with neurophobia were less likely to consider a career in neurology (OR 0.32, 95% CI: 0.25 to 0.41).

CONCLUSIONS

Neurophobia affects a substantial proportion of medical trainees and practitioners globally, with variation across education and practice levels. Addressing contributing factors through targeted interventions may help mitigate neurophobia and improve neurological care. Further studies should focus on specific interventions.

摘要

背景

神经恐惧症,即对神经病学的恐惧,是医学教育和实践中公认的全球性挑战。本系统评价和荟萃分析旨在量化医学生、住院医师和非神经科医生中神经恐惧症的患病率,确定促成因素(包括基础科学/临床整合不足),并探讨其对神经病学护理的影响。

方法

我们系统检索了PubMed、Scopus和谷歌学术,查找2000年至2024年发表的关于神经恐惧症的研究。两名独立评审员筛选研究、提取数据,并使用纽卡斯尔-渥太华量表评估其质量。进行随机效应荟萃分析以估计神经恐惧症的合并患病率。对异质性和发表偏倚进行统计学检验。

结果

在最初的1245项研究中,32项符合纳入标准。神经恐惧症的合并患病率为47.2%(95%置信区间:39.8%至54.6%),存在显著异质性(I²=98.7%,p<0.001)。亚组分析显示,医学生中的患病率(52.3%,95%置信区间:44.1%至60.5%)高于住院医师和医生(41.9%,95%置信区间:33.7%至50.1%)。主要促成因素包括认为神经病学复杂(比值比:3.2,95%置信区间:2.7至3.8)和培训期间接触不足(比值比:2.8,95%置信区间:2.3至3.3)。患有神经恐惧症的个体从事神经病学职业的可能性较小(比值比0.32,95%置信区间:0.25至0.41)。

结论

神经恐惧症影响着全球相当一部分医学实习生和从业者,不同教育和实践水平存在差异。通过有针对性的干预措施解决促成因素可能有助于减轻神经恐惧症并改善神经病学护理。进一步的研究应侧重于具体干预措施。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/750b/12096978/e713f8c501d6/bmjno-7-1-g001.jpg

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