Help-seeking in A&E for Functional Neurological Disorder (FND): a mixed methods study of patient experiences of a war...

This mixed-method study aimed to i) describe characteristics of those who attend A&E frequently (FAs) with and without Functional Neurological Disorder (FND); ii) to explore patients' with FND's experiences of help-seeking in A&E.

First, a database of NHS FAs (10+ times in a year; n = 99) from one hospital was analysed. Next, FAs with FND (n = 6) were interviewed about their help-seeking.

From stage 1, 61% of all FAs were female, had visited A&E a mean of 16 times in the past 12 months and had been referred to a wide range of clinics. No significant differences were found between FND (n = 11) and non FND patients (n = 88). In Stage 2, thematic analysis described four main themes: i) 'symptom experience'; ii) 'feelings of isolation'; iii) 'Healthcare Professional (HCP) barriers to care'; iv) 'HCP perseverance'. Transcending these themes was a transition from uncertainty to judgement as patients eventually obtained a diagnosis of FND. Overarching all themes was the sense of FND as a war on two fronts as patients battled both their symptoms and the health care system.

Help seeking for FND involves a battle which may be improved by educating HCPs and offering a specialised clinic.