Examining the impact of healthcare professional attitudes to functional neurological disorders and the lived experience of facioscapulohumeral muscular dystrophy
التفاصيل البيبلوغرافية
العنوان:
Examining the impact of healthcare professional attitudes to functional neurological disorders and the lived experience of facioscapulohumeral muscular dystrophy
This thesis contains two chapters, including a systematic review chapter and an empirical chapter, followed by a brief reflective appendix. A range of research methodologies were employed to investigate both patient and healthcare practitioners' experiences and attitudes toward neurological presentations. The systematic review is a qualitative synthesis of the literature exploring the lived experience of people with Facioscapulohumeral Muscular Dystrophy (FSHD). The systematic review methodology is outlined in detail. Five descriptive themes and two analytical themes which arose from qualitative synthesis are presented and discussed in the context of models which may be applied to understanding the lived experience of this population and the clinical implications of the review findings. The second chapter is an empirical study of the attitudes of healthcare practitioners toward Functional Neurological Disorder (FND) and associated clinical decision-making. Experimental methods were used to collect quantitative data on the implicit and explicit attitudes of healthcare practitioners regarding the legitimacy of FND, as well as treatment optimism and clinician confidence in working with people with FND. Participants also made treatment recommendations for neurological case vignettes, including FND and non-FND presentations. Statistical analysis revealed uncertainty among clinicians about the legitimacy of FND at implicit and explicit levels. Attitudes about FND-illegitimacy were associated with lower likelihood of referral to physical interventions such as physiotherapy, recommended in best practice guidelines for FND. These findings are discussed in terms of the strengths and limitations of the study and the implications for clinical practice.
