Dados do Trabalho

Título

Level of confidence of healthcare providers in diagnosing and treating functional seizures in Brazil: A cross-sectional study

Introdução

Functional seizures (FS) are a common differential diagnosis of epilepsy. However, not all FS-involved healthcare providers (HCP) are confident in diagnosing and treating this disorder.

Objetivo

To compare the level of confidence of HCP in diagnosing and treating FS in Brazil.

Método

Neurologists, psychiatrists, and psychologists who work in the health sector respond to an online questionnaire. Researchers publicized the link to the survey via email and social media. The level of confidence in diagnosing and treating PNES were questioned separately and self-rated on a 5-point scale (1 = none; 2 = low; 3 = medium; 4 = high; 5 = very high). Kruskal-Wallis test was used to compare the confidence level distribution across categories of HCP (α = .05). Data were collected from February 22 to May 4, 2022.

Resultados

A total of 515 HCP (mean age of 39.4 ± 11.4 yrs [range 22-75 yrs]; 68% female) respond to the survey: 190 neurologists (37%), 82 psychiatrists (16%), and 243 psychologists (47%). The respondents represented the public and private healthcare sectors from all geographical regions of Brazil. Fifty-four (28%) respondents were neurologists with expertise in epilepsy, 54% were psychologists with expertise in clinical psychology, and 26% were psychiatrists with expertise in psychotherapy. Almost all neurologists (94%) and psychiatrists (96%) have diagnosed or treated at least one adult patient with FS. In contrast, a minority (43%) of psychologists reported experience with these patients. Psychologists' level of training in FS was lower than psychiatrists and neurologists (Mdn 2 points vs. 3 pts vs. 4 pts, respectively) (p< .01). Also, psychologists' level of confidence in diagnosing FS in adults was lower than psychiatrists and neurologists (Mdn 2 pts vs. 3 pts vs. 3 pts, respectively) (p<.01). The level of confidence in treating FS in adults differed among psychologists, neurologists, and psychiatrists, who had the highest level of confidence (Mdn 2 pts vs. 3 pts vs. 3.5 pts, respectively) (p< .01).

Conclusão

Psychologists' confidence in diagnosing and treating FS in adults is lower than neurologists and psychiatrists. Since psychological treatment is the treatment of choice for FS, patients will likely face difficulties in Brazil accessing psychologists with expertise.

Palavras-chave

Functional seizures, Patient care team, Clinical Skills