Providers' perspectives on treating psychogenic nonepileptic seizures: Frustration and hope
ABSTRACT Recent diagnostic and treatment advances in psychogenic nonepileptic seizures (PNES) have the potential to improve care for patients, but little is known about the current state of PNES care delivery in the Veterans Health Administration (VA). We conducted semistructured interviews with 74 health-care clinicians and workers in the VA, eliciting provider perceptions of PNES care. Data were analyzed according to principles of Grounded Theory. The results revealed variation in care and two emergent domain themes of frustration and hope. Frustration was manifest in subthemes including Complexity, Patient Acceptance, Uncertainty About Treatment, Need for Evidence-based Treatment, and Failure of Cross-Disciplinary Collaboration between neurologists and mental health providers. Hope encompassed subthemes of Positive Attitudes, Developing Cross-Disciplinary Treatment, and Specific PNES Care. Increased resources for diagnosing, treating, and researching PNES have improved awareness of the disorder. More research is needed to understand patients' and caregivers' perceptions of PNES care.
Full-textDOI: · Available from: Katharine Kaye McMillan, Aug 20, 2014
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ABSTRACT: This article is part of a Special 15th Anniversary Issue. Copyright © 2014 Elsevier Inc. All rights reserved.Epilepsy & Behavior 11/2014; 40:13-5. DOI:10.1016/j.yebeh.2014.09.059 · 2.26 Impact Factor
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ABSTRACT: The aim of the study was to explore the life experiences of South Africans who have been diagnosed as having PNES, with a focus on the aspects of the challenges which these individuals face, as well as the resources and coping strategies which are either made available to them or used by them in order to cope with PNES. Ten semi-structured interviews were analysed by means of thematic analysis in order to explore themes around challenges and resources for those diagnosed with PNES. Various challenges were revealed by participants, as well as the resources used in order to deal with these challenges associated with being diagnosed with PNES. Some of the challenges included unexpected seizures, medical professionals, belief systems as well as family. However, resources to counteract these challenges were social support, medical professional as well as religion and spirituality. Although many challenges are encountered by those who are diagnosed with PNES, there are substantial resources from which these individuals draw in order to live fulfilling and satisfactory lives. As more information and research is accumulated, more resources may become available to benefit these individuals and allow them to recover from PNES. It should be noted that medical professionals were described as both a challenge as well as a resource for people with PNES. Therefore, we can conclude that these individuals are key in the experiences of those who have been diagnosed with PNES, and that they play a role on not only a diagnostic level, but also in providing support, information, as well as therapeutic benefits. Copyright © 2015 British Epilepsy Association. Published by Elsevier Ltd. All rights reserved.Seizure 05/2015; 30. DOI:10.1016/j.seizure.2015.05.008 · 1.82 Impact Factor