An exploration of factors influencing healthcare professionals’ perceptions towards functional neurological disorders.

Abstract

Functional neurological disorders (FND) sit under the umbrella of functional somatic syndromes (FSS), which have been widely recognised as challenging and controversial and are often associated with negative perceptions by health care professionals (HCP). Although recognised as a barrier to care, little is understood about the psychological processes influencing such negative views. Chapter 1 reports a systematic review of the quantitative and qualitative literature, exploring the psychological factors that are underpinning HCP experiences of working with FSS and influencing such perceptions. Narrative synthesis was used to explore 24 papers, 11 qualitative, six quantitative and seven mix methods. This identified eight themes that influenced HCP’s negative perceptions of FSS, including perceived knowledge, support, sitting with uncertainty, confidence, doubt, interpersonal difficulties, felt sense of hopelessness and felt sense of incompetence. These findings suggest that negative perceptions towards FSS may be experienced as a defence against these challenges. Limitations were noted including the lack of validated measures and the higher representation of doctors present in the studies, emphasising the need for further research.
Findings from Chapter 1 also noted that the majority of the studies included in the theme of ‘doubt’, were related to FND. This refers to a set of neurological symptoms, recognised as a neurobiological response to psychological distress and results in unconscious physical symptoms. Often misunderstood, patients frequently attend healthcare services, ensuing unnecessary medical investigations and a high financial impact. Effective communication of this diagnosis can be an important intervention, resulting in positive clinical outcomes. However, one identified barrier to achieving this is HCP’s negative perceptions towards FND. The study reported in Chapter 2 aimed to explore perceptions of HCPs working in either mental health settings or emergency departments, to consider factors that may influence perceptions. A cross-sectional survey containing quantitative and qualitative questions that aimed to identify psychological and
professional factors that predict HCPs perceptions towards FND, was distributed to NHS HCP’s. Results from 72 participants (20 in ED and 52 in Mental Health), aged 24-60, found younger HCPs, those working in mental health, and those with more training and experience working with FND, held significantly better perceptions. Beyond this, confidence working with complexity was the most significant predictor of positive perceptions. Qualitative findings suggested HCPs felt more education and collaborative working for FND is needed. These findings suggest that developing a training programme for HCP’s, providing more information of FND and skills in working with complexity, will support HCP/patient interactions, improve communication of FND and ultimately clinical outcomes.

More information

Identifiers

ORCID for Sarah Kirby: orcid.org/0000-0003-1759-1356

Catalogue record

Export record