Abstract：
BACKGROUND: Functional neurological symptom disorder (FND) is characterised by neurological symptoms that are incompatible with recognised neurological or medical conditions. The condition is common in neurology clinics and causes significant morbidity, though timely access to specialist care is difficult. We sought to characterise the availability and clinical practice of specialist FND clinics across Australia and New Zealand.
METHODS: Clinicians or coordinators involved in running specialist FND clinics were identified through clinical contacts with further recruitment by snowball sampling and contacting patient organisations. All clinics completed a survey about details of service delivery, including clinical model, referral sources, criteria, demand, staffing, interventions, clinical data collection, and funding.
RESULTS: We identified 16 clinics across Australia and New Zealand. Of these, 12 were in capital cities and four were in regional centres. Three of these focused on paediatric patients and 13 focused on adults. Clinics varied in their clinical model, referral sources, criteria, staffing, interventions, data collection, and funding. Most clinics reported challenges related to coping with demand and obtaining adequate funding.
CONCLUSIONS: FND clinics in Australia and New Zealand appear to be concentrated predominantly in metropolitan areas and vary considerably in their referral sources, clinical data collection, and models of care. Reported challenges in meeting demand indicate a need for greater resources. The heterogeneity across clinics suggests a need to harmonise clinical standards to facilitate access to evidence-based care.
METHODS: Clinicians or coordinators involved in running specialist FND clinics were identified through clinical contacts with further recruitment by snowball sampling and contacting patient organisations. All clinics completed a survey about details of service delivery, including clinical model, referral sources, criteria, demand, staffing, interventions, clinical data collection, and funding.
RESULTS: We identified 16 clinics across Australia and New Zealand. Of these, 12 were in capital cities and four were in regional centres. Three of these focused on paediatric patients and 13 focused on adults. Clinics varied in their clinical model, referral sources, criteria, staffing, interventions, data collection, and funding. Most clinics reported challenges related to coping with demand and obtaining adequate funding.
CONCLUSIONS: FND clinics in Australia and New Zealand appear to be concentrated predominantly in metropolitan areas and vary considerably in their referral sources, clinical data collection, and models of care. Reported challenges in meeting demand indicate a need for greater resources. The heterogeneity across clinics suggests a need to harmonise clinical standards to facilitate access to evidence-based care.
摘要：
背景:功能性神经症状障碍(FND)的特征在于与公认的神经或医学病症不相容的神经症状。这种情况在神经科诊所很常见，会导致严重的发病率，虽然及时获得专科护理是困难的。我们试图描述澳大利亚和新西兰专业FND诊所的可用性和临床实践。
方法：通过临床接触，通过雪球采样和联系患者组织进一步招募，确定了参与运营FND专科诊所的临床医生或协调员。所有诊所都完成了一项关于服务交付细节的调查，包括临床模型，转介来源，标准,需求,人员配备，干预措施，临床数据收集，和资金。
结果：我们在澳大利亚和新西兰确定了16家诊所。其中,12个在首都，4个在区域中心。其中3例集中于儿科患者，13例集中于成年人。诊所的临床模型各不相同，转介来源，标准,人员配备，干预措施，数据收集，和资金。大多数诊所报告了与应对需求和获得足够资金有关的挑战。
结论：澳大利亚和新西兰的FND诊所似乎主要集中在大都市地区，其转诊来源差异很大，临床数据收集，和护理模式。报告的满足需求方面的挑战表明需要更多的资源。诊所间的异质性表明，需要协调临床标准，以促进获得循证护理。
方法：通过临床接触，通过雪球采样和联系患者组织进一步招募，确定了参与运营FND专科诊所的临床医生或协调员。所有诊所都完成了一项关于服务交付细节的调查，包括临床模型，转介来源，标准,需求,人员配备，干预措施，临床数据收集，和资金。
结果：我们在澳大利亚和新西兰确定了16家诊所。其中,12个在首都，4个在区域中心。其中3例集中于儿科患者，13例集中于成年人。诊所的临床模型各不相同，转介来源，标准,人员配备，干预措施，数据收集，和资金。大多数诊所报告了与应对需求和获得足够资金有关的挑战。
结论：澳大利亚和新西兰的FND诊所似乎主要集中在大都市地区，其转诊来源差异很大，临床数据收集，和护理模式。报告的满足需求方面的挑战表明需要更多的资源。诊所间的异质性表明，需要协调临床标准，以促进获得循证护理。
