Neurologists’ Attitudes Towards Psychogenic Non-epileptic Seizures
Abstract number :
2.344
Submission category :
13. Health Services (Delivery of Care, Access to Care, Health Care Models)
Year :
2022
Submission ID :
2204166
Source :
www.aesnet.org
Presentation date :
12/4/2022 12:00:00 PM
Published date :
Nov 22, 2022, 05:23 AM
Authors :
Emily Liu, MD – UCSF; Colin Ellis, MD – Assistant Professor, Neurology, University of Pennsylvania; Dominic Sisti, PhD – Associate Professor, University of Pennsylvania; Andrea Segal, MS, MPH – University of Pennsylvania
Rationale: Patients with psychogenic non-epileptic seizures (PNES) consistently report negative encounters with healthcare providers (HCPs), where they feel negatively stereotyped, delegitimized, and held culpable for events.1 These encounters create psychosocial strain, preventing individuals from seeking care, undermining adherence, and negatively impacting health outcomes.1 However, stigmatizing attitudes among HCPs have not been well studied. In this study, we sought to (1) explore attitudes of neurologists, as a crucial HCP demographic, towards patients with PNES and (2) determine associations between attributes of neurologists and stigmatizing attitudes towards PNES._x000D_
Methods: We created modified stigma scales for PNES, adapted from two validated stigma scales -- the Opening Minds Stigma Scale for Healthcare Providers (OMS-HC) and the Stigma Scale of Epilepsy (SSE) -- with responses graded on a Likert scale.2,3 These scales were distributed as part of an online survey on REDCap that also included demographic questions and questions on participants’ professional characteristics. A link was distributed to the Penn neurology department, alumni of the Penn epilepsy program, and residency and fellowship directors of major training programs in the United States. We tested for associations between demographic/professional characteristics and stigma scores.
Results: We received 94 completed surveys, with 34% of responses from trainees and 66% from attendings. 53% of respondents were practicing in an academic medical setting at the time of the survey. 65% of respondents had dedicated lectures on PNES, and 48% of respondents had teaching related to resources and psychotherapy for patients with PNES. Scores on each of the two stigma scales followed a normal distribution. Scores for questions adapted from OMS-HC did not correlate with those adapted from SSE. There were no statistically significant differences across education, training, and clinical experiences._x000D_
Conclusions: Stigma is a multifaceted, multidisciplinary, and contextual entity. Our study highlights the challenge of validating objective measures for stigma in the absence of a gold standard. We also did not find any predictors of stigmatizing attitudes among the variables measured. Next steps include refinement of our stigma scale to specifically explore stigma by neurologists in PNES through focus groups and interviews. We also hope to provide a platform for meaningful discourse on empiric methodology in stigma research.
References:
1. Robson C, Lian OS. Blaming, shaming, humiliation: stigmatising medical interactions among people with non-epileptic seizures. Wellcome Open Res. 2017;2:55. doi:10.12688/wellcomeopenres.12133.2
2. Fernandes PT, Salgado PCB, Noronha ALA, Sander JW, Li LM. Stigma scale of epilepsy: validation process. Arquivos de Neuro-Psiquiatria. 2007;65(suppl 1):35-42. doi:10.1590/s0004-282x2007001000006
3. Kassam A, Papish A, Modgill G, Patten S. The development and psychometric properties of a new scale to measure mental illness related stigma by health care providers: The Opening Minds Scale for Health Care Providers (OMS-HC). BMC Psychiatry. 2012;12(1). doi:10.1186/1471-244x-12-62
Funding: None
Health Services (Delivery of Care, Access to Care, Health Care Models)