Provider Perspectives of Barriers to Delivering Care for Pediatric Functional Neurological Disorder: A Thematic Analysis

IF 3.2 3区医学 Q2 CLINICAL NEUROLOGY

Pediatric neurology Pub Date : 2025-01-27 DOI:10.1016/j.pediatrneurol.2025.01.011

Jeannette M. Iskander PhD , Jason Kreuzman OTR/L , Meagan Watson MPH, MBA , Gayle Chesley PhD , Karen Zeribi MHS , Amanda Hopper MLS , Tamara Powell PhD , Laura Simon MD , Aaron D. Fobian PhD

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引用次数: 0

Abstract

Background

Functional neurological disorder (FND) is a multinetwork brain disorder existing at the intersection of neurology and psychiatry. FND often takes significant time to receive diagnosis and treatment. Given these delays, the purpose of the present study was to identify barriers to FND care from the provider perspective.

Methods

The Functional Neurological Disorder Society Pediatric Special Interest Group asked pediatric FND providers to specify barriers to FND treatment in their center in the United States. Two authors conducted thematic analyses to extract themes between respondents’ qualitative responses.

Results

Our analysis found that the US health care system is not adequately designed to provide timely and sufficient treatment for pediatric FND. Four subthemes emerged. First, providers identified limited access to health care professionals (HCPs) with specialized expertise in pediatric FND. The second delineated the lack of HCP education and competence in FND. Third, providers indicated the challenge of coordinating care and establishing bidirectional communication with their colleagues. Finally, providers identified financial support, including insurance coverage, as a barrier.

Conclusions

The present study highlights barriers to care for pediatric patients with FND from the provider perspective in the United States. These barriers existed regardless of geography, treatment type, discipline, or specialty highlighting opportunities to intervene. By improving provider education, general practitioners may gain increased confidence in quickly delivering an FND diagnosis; this could also allow additional providers to become experts in treating FND, thus decreasing delays to initiating care. Additionally, advocacy for increased insurance coverage may also help to eliminate treatment-related disparities for pediatric FND.

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来源期刊

Pediatric neurology 医学-临床神经学

CiteScore

4.80

自引率

2.60%

发文量

176

审稿时长

78 days

期刊介绍： Pediatric Neurology publishes timely peer-reviewed clinical and research articles covering all aspects of the developing nervous system. Pediatric Neurology features up-to-the-minute publication of the latest advances in the diagnosis, management, and treatment of pediatric neurologic disorders. The journal''s editor, E. Steve Roach, in conjunction with the team of Associate Editors, heads an internationally recognized editorial board, ensuring the most authoritative and extensive coverage of the field. Among the topics covered are: epilepsy, mitochondrial diseases, congenital malformations, chromosomopathies, peripheral neuropathies, perinatal and childhood stroke, cerebral palsy, as well as other diseases affecting the developing nervous system.