A meta-ethnographic synthesis of the experiences of stigma amongst people with functional neurological disorder

Foley, Ciarán; Kirkby, Antonia; Eccles, Fiona

doi:10.1080/09638288.2022.2155714

Cited by 15 publications

(12 citation statements)

References 56 publications

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“…These perceived conflicts were also underpinned by perceptions of, and anticipation of, enacted stigma. The perceived stigma appeared to impact how participants viewed their own self‐identity, which is consistent with findings from a recent meta‐ethnographic synthesis (Foley et al, 2022). Stigma appeared to function across three levels: intra‐personally, interpersonally and structurally (Goffman, 1963; Link & Phelan, 2001).…”

Section: Discussionsupporting

confidence: 87%

“…There is considerable research highlighting that broader mental health stigma impacts seeking and participating in mental health care (Corrigan et al, 2014). Additionally, a recent systematic review highlighted how individuals may attempt to manage FND stigma by adopting coping styles that inadvertently worsen their condition (e.g., self‐isolation; Foley et al, 2022). Although it is acknowledged that individuals with FND experience significant stigma, current research has focused predominately on experiences in medical settings.…”

Section: Introductionmentioning

confidence: 99%

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Functional neurological disorder: A qualitative study exploring individuals' experiences of psychological services

Staton,

Dawson,

Merdian

et al. 2023

Psychol Psychother

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ObjectivesIndividuals with a diagnosis of FND report experiencing stigma in medical settings, however, there is a paucity of research exploring their experiences in psychological services. The aim of this research was to explore experiences of accessing UK psychological services, from the perspective of those with FND.MethodsThis study utilised a qualitative approach with data collected from semi‐structured interviews (n = 15) and analysed using reflexive thematic analysis.ResultsOne superordinate theme, ‘the stigmatised self within the therapeutic relationship’, and five interrelated subthemes were identified: ‘internalised stigma and self‐doubt’, ‘selective disclosure to professionals’, ‘perceptions of psychological explanations’, ‘having to educate the professionals’ and ‘attunement and trust within the therapeutic relationship’. Positive therapeutic relationships were perceived to mitigate the impact of these perceived barriers. The conceptualisation of FND and the perception of how this was responded to by services and professionals was a central tenet throughout the related themes.ConclusionsIntra‐personal, interpersonal and organisational stigma impact access and engagement to psychological treatment. The findings of this study highlight the need for increased training provision for practitioners with a focus on actively challenging FND stigma within services at both an individual and systemic level.

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Section: Discussionsupporting

confidence: 87%

Section: Introductionmentioning

confidence: 99%

Functional neurological disorder: A qualitative study exploring individuals' experiences of psychological services

Staton,

Dawson,

Merdian

et al. 2023

Psychol Psychother

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show abstract

“…Patients with FND are typically seen either in extremely busy general neurology clinics in acute hospitals or in general practices, where rushed consultations are likely to be unsatisfactory for clinician and patient alike. Patients with FND frequently report negative relationships with HCPs in Ireland and elsewhere (O'Keeffe et al., 2021 ; Rawlings & Reuber, 2016 ) and experience a sense of invalidation regarding symptoms (Foley et al., 2022 ). It is possible that these difficulties are amplified by insufficient clinic time.…”

Section: Discussionmentioning

confidence: 99%

“…Patients with FND often report delayed and poor communication in diagnosis, negative relationships with HCPs and challenges in accessing services and supports (O'Keeffe et al., 2021 ; Rawlings & Reuber, 2016 ). The patient experience can often involve feelings of stigma and a sense of invalidation regarding symptoms (Foley et al., 2022 ).…”

Section: Introductionmentioning

confidence: 99%

Attitudes and perceptions of Irish health care professionals regarding functional neurological disorder: A national survey

Vance,

Clarke,

O'Keeffe

et al. 2024

Brain and Behavior

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BackgroundFunctional neurological disorder (FND) is a common and often disabling condition. Limited access to services for FND poses challenges both for patients and their health care providers. This survey explored the attitudes, experiences, support needs and training needs of health care professionals (HCPs) who provide care to individuals with FND in Ireland.MethodsA broad range of HCPs working with patients with FND in Ireland partook in an anonymous online 12‐item survey. Participants were recruited via professional bodies and snowball convenience sampling utilising social media and email invitation. Descriptive and inferential statistics were employed to analyze data.ResultsA total of 314 HCPs working in Ireland completed the survey. 80% were female and over half worked in their current role for more than 10 years. 75% of the sample encountered three or less individuals with FND per month. Identified service‐related challenges to effective patient care included insufficient clinic time, lack of confidence explaining the diagnosis, and the need for greater access to specialist support. Data revealed persisting negative attitudes toward FND patients among a proportion of respondents. The majority of respondents did not feel they received adequate education on FND, with the exception of neurologists, of whom 65% felt adequately trained. The majority of respondents (85%) also felt that people with FND did not have access to appropriate FND services in Ireland.ConclusionThis study indicates that there is a significant need to improve FND education among HCPs in Ireland, in addition to developing appropriately resourced, integrated, multidisciplinary care pathways for the FND patient group.

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“…Earlier this year, a paper in the European Journal of Neurology ( Mason et al, 2023 ) cited a different SNSS paper ( Stone et al, 2009 ) to support the assertion that FND prevalence at outpatient neurology clinics was 5.4 %—far lower than the percentage needed to be the “2nd most common” diagnosis. Moreover, the authors of another paper ( Foley et al, 2022 ) have recently issued a correction for the same misstatement of FND prevalence from the SNSS findings as the one identified in Perez et al…”

mentioning

confidence: 91%

Correspondence: Inaccurate reference leads to tripling of reported FND prevalence

2024

NeuroImage: Clinical

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A meta-ethnographic synthesis of the experiences of stigma amongst people with functional neurological disorder

Cited by 15 publications

References 56 publications

Functional neurological disorder: A qualitative study exploring individuals' experiences of psychological services

Functional neurological disorder: A qualitative study exploring individuals' experiences of psychological services

Attitudes and perceptions of Irish health care professionals regarding functional neurological disorder: A national survey

Correspondence: Inaccurate reference leads to tripling of reported FND prevalence

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