Changing the culture of care for children and adolescents with functional neurological disorder

Epilepsy & Behavior Reports

Janet Baker¹  Stephen Scher²  Tyson Sawchuk³  Jeff L. Waugh⁴  Kasia Kozlowska⁵  Aaron D. Fobian⁶  Helene Helgeland⁷ 

[1] Alberta Children's Hospital Research Institute, Calgary, AB, Canada;Alberta Children's Hospital, Calgary, AB, Canada;University of Sydney Medical School, Sydney, NSW, Australia;Westmead Institute for Medical Research, Westmead, NSW, Australia;Department of Psychological Medicine, The Children’s Hospital at Westmead, Westmead, NSW, Australia;Division of Child Neurology, Department of Pediatrics, University of Texas Southwestern, Dallas, TX, USA;University of Calgary, Cumming School of Medicine, Department of Pediatrics, AB, Canada;

关键词: Functional neurological disorder (FND);    Functional seizures;    Stigma;    Children and adolescents;    Cultural change;    Clinical ethics;   

DOI  :  

来源: DOAJ

【 摘 要 】

As members of a multidisciplinary team of professionals who treat children and adolescents with functional neurological (conversion) disorder (FND), we highlight the pressing need to develop an FND-informed culture of care that takes into account recent advances in our understanding of this group of patients. Stories of clinical encounters in health care settings from around the world—told by children and adolescents with FND, their parents, and health professionals—portray an outdated culture of care characterized by iatrogenic stigma, erosion of empathy and compassion within the clinician-patient relationship, and a lack of understanding of FND and its complex neurobiology. After a brief exploration of the outdated culture, we share our counterstories: how we and our colleagues have worked, and continue to work, to create an FND-informed culture in the health systems where we practice. We discuss the therapeutic use of child-friendly language. We also discuss a range of structural, educational, and process interventions that can be used to promote FND-informed beliefs and attitudes, FND-informed clinician-patient encounters, and FND-informed referral processes, treatment pathways, and therapeutic interventions.

【 授权许可】

Unknown