Abstract：
OBJECTIVE: The purpose of this systematic review was to evaluate stigma and Functional Neurological Disorder (FND) regarding: 1) prevalence and associated factors, 2) the nature and context of stigma in FND, and 3) stigma-reduction interventions.
METHODS: We searched four relevant databases from inception to December 2023, using search terms relevant to FND and stigma themes. We employed the method of synthesis by \"aggregation and configuration\" to synthesise and analyse the data into emergent themes.
RESULTS: We found 127 studies, spanning 148 countries, involving 18,886 participants. Of these, 4889 were patients, 13,123 were healthcare professionals, and 526 were caregivers. Quantitatively, stigma has been mainly studied in patients with functional seizures, and was higher than patients with epilepsy in three studies. Stigma experienced by patients is associated with poorer quality of life and caregiver burden. We found 10 themes and 29 subthemes revealing stigma as a systemic process, with intrapersonal, interpersonal and structural aspects. Few studies examined the perspective of caregivers, the public or online community. We identified six anti-stigma interventions.
CONCLUSIONS: Stigma in FND is a layered process, and affects patient quality of life and provision of care. Stigma needs to be addressed from the top structures, at governmental level, so that appropriate care pathways can be created, giving patients with FND parity of esteem with other medical conditions.
METHODS: We searched four relevant databases from inception to December 2023, using search terms relevant to FND and stigma themes. We employed the method of synthesis by \"aggregation and configuration\" to synthesise and analyse the data into emergent themes.
RESULTS: We found 127 studies, spanning 148 countries, involving 18,886 participants. Of these, 4889 were patients, 13,123 were healthcare professionals, and 526 were caregivers. Quantitatively, stigma has been mainly studied in patients with functional seizures, and was higher than patients with epilepsy in three studies. Stigma experienced by patients is associated with poorer quality of life and caregiver burden. We found 10 themes and 29 subthemes revealing stigma as a systemic process, with intrapersonal, interpersonal and structural aspects. Few studies examined the perspective of caregivers, the public or online community. We identified six anti-stigma interventions.
CONCLUSIONS: Stigma in FND is a layered process, and affects patient quality of life and provision of care. Stigma needs to be addressed from the top structures, at governmental level, so that appropriate care pathways can be created, giving patients with FND parity of esteem with other medical conditions.
摘要：
目的：本系统评价的目的是评估病耻感和功能性神经障碍（FND），包括：1）患病率和相关因素，2)FND中污名的性质和背景，和3)减少污名的干预措施。
方法：从成立到2023年12月，我们使用与FND和污名主题相关的搜索词搜索了四个相关数据库。我们采用“聚合和配置”的合成方法将数据合成和分析为紧急主题。
结果：我们发现了127项研究，跨越148个国家，涉及18,886名参与者。其中,4889名患者，13,123名是医疗保健专业人员，526名护理人员。定量地,病耻感主要在功能性癫痫患者中进行研究，在三项研究中高于癫痫患者。患者经历的污名与较差的生活质量和照顾者负担有关。我们发现10个主题和29个次主题揭示了污名作为一个系统过程，与内线，人际和结构方面。很少有研究考察了护理人员的观点，公共或在线社区。我们确定了六种反污名干预措施。
结论：FND中的污名是一个分层过程，并影响患者的生活质量和护理。耻辱需要从高层结构开始解决，在政府层面，这样就可以创造适当的护理途径，给予FND患者与其他医疗条件同等的尊重。
方法：从成立到2023年12月，我们使用与FND和污名主题相关的搜索词搜索了四个相关数据库。我们采用“聚合和配置”的合成方法将数据合成和分析为紧急主题。
结果：我们发现了127项研究，跨越148个国家，涉及18,886名参与者。其中,4889名患者，13,123名是医疗保健专业人员，526名护理人员。定量地,病耻感主要在功能性癫痫患者中进行研究，在三项研究中高于癫痫患者。患者经历的污名与较差的生活质量和照顾者负担有关。我们发现10个主题和29个次主题揭示了污名作为一个系统过程，与内线，人际和结构方面。很少有研究考察了护理人员的观点，公共或在线社区。我们确定了六种反污名干预措施。
结论：FND中的污名是一个分层过程，并影响患者的生活质量和护理。耻辱需要从高层结构开始解决，在政府层面，这样就可以创造适当的护理途径，给予FND患者与其他医疗条件同等的尊重。
