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CC BY 4.0 · Arq Neuropsiquiatr 2022; 80(11): 1097-1103
DOI: 10.1055/s-0042-1758646
Original Article

Knowledge and emotional attitudes of health care practitioners regarding patients with psychogenic nonepileptic seizures

Conhecimento e atitudes emocionais dos profissionais de saúde acerca de pacientes com convulsão psicogênica não epiléptica
Thani Sheikh Saker 
1   Rambam Health Care Center, Neurology Department, Haifa, Israel.
,
Mark Katson 
1   Rambam Health Care Center, Neurology Department, Haifa, Israel.
,
Sari Eran Herskovitz 
2   Ministry of Education, Department of Special Education, Afula, Israel.
,
Moshe Herskovitz 
1   Rambam Health Care Center, Neurology Department, Haifa, Israel.
3   Technion Institute of Technology, Faculty of Medicine, Haifa, Israel.
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Abstract

Background Psychogenic nonepileptic seizures (PNESs) are paroxysmal events that resemble epileptic seizures without concomitant changes in electroencephalograms (EEGs) or any other physiological cause. These seizures are one of the most common and dramatic conversion disorders. First responders treat many PNES patients with unnecessary emergency abortive medication and sometimes even intubate them. Several of our PNES patients have complained they have experienced harsh attitudes from health care practitioners (HCPs), especially during their stay in the emergency room (ER).

Objective To assess the emotional attitude of HCPs toward PNES patients.

Methods We handed a questionnaire containing 23 questions regarding PNES patients to HCPs from emergency medicine, internal medicine, and neurology disciplines. The questions dealt with three categories: diagnosis, management, and emotional attitudes.

Results Overall, 47 HCPs participated in this study: 11 ER, 18 internal medicine, and 18 neurology practitioners. The HCP from those disciplines showed high knowledge and good management practice of PNES patients. On the other hand, the HCPs agreed with most emotional attitude statements regarding PNES patients, reflecting a high percentage of negative emotional attitudes toward this group of patients. We did not find any correlation between negative emotional attitude and HCP department, profession, or seniority.

Conclusions Although HCPs in our center perform good management practice regarding PNES patients, most reported a negative emotional attitude. This finding implies that what PNES patients feel regarding the harsh attitudes is also reflected by HCP views. Emotional attitudes towards PNES patients may not depend solely on the level of knowledge of the HCPs.

Resumo

Antecedentes Crises não epilépticas psicogênicas (CNEPs) são eventos paroxísticos que se assemelham a crises epilépticas sem alterações concomitantes nos eletroencefalogramas (EEGs) ou não causadas por qualquer outra causa fisiológica. Essas convulsões são um dos distúrbios de conversão mais comuns e dramáticos. Os socorristas tratam muitos pacientes com CNEP com medicamentos abortivos de emergência desnecessariamente e às vezes até os entubam. Vários de nossos pacientes com CNEP queixaram-se de atitudes duras dos profissionais de saúde (HCPs), especialmente durante a permanência na sala de emergência (SE).

Objetivo Avaliar a atitude emocional dos profissionais de saúde em relação aos pacientes com CNEP.

Métodos Entregamos um questionário contendo 23 perguntas sobre pacientes com CNEP aos profissionais de saúde das disciplinas de medicina de emergência, medicina interna e neurologia. As questões tratavam de três categorias: diagnóstico, manejo e atitudes emocionais.

Resultados No geral, 47 profissionais de saúde participaram deste estudo: 11 ER, 18 medicina interna e 18 profissionais de neurologia. Os profissionais de saúde dessas disciplinas apresentaram alto conhecimento e boa prática de manejo dos pacientes da CNEP. Por outro lado, os profissionais de saúde concordaram com as afirmações da maioria das atitudes emocionais em relação aos pacientes da CNEP, refletindo um alto percentual de atitudes emocionais negativas em relação a esse grupo de pacientes. Não encontramos nenhuma correlação entre atitude emocional negativa e departamento de HCP, profissão ou antiguidade.

Conclusões Embora os profissionais de saúde de nosso centro tenham uma boa prática profissional de manejo em relação aos pacientes com CNEP, a maioria relatou uma atitude emocional negativa. Esse achado implica que o que os pacientes da PNES sentem em relação às atitudes duras também se reflete na visão do HCP. Atitudes emocionais em relação aos pacientes da CNEP podem não depender apenas do nível de conhecimento dos profissionais de saúde.

Keywords

Attitude - Seizures - Health Personnel - Health Surveys

Palavras-chave

Atitude - Convulsões - Pessoal de Saúde - Inquéritos Epidemiológicos

Authors' Contributions

TSS: conceptualization, analysis and interpretation of data, and revision of the manuscript; MK: analysis and interpretation of data; SEH: conceptualization, analysis and interpretation of data, and revision of the manuscript; MH: conceptualization of the study.




Publication History

Received: 17 August 2021

Accepted: 04 March 2022

Article published online:
28 December 2022

© 2022. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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