ABSTRACT
Pervasive refusal syndrome (PRS)/pervasive arousal withdrawal syndrome (PAWS) and conversion disorder (CD) are two rare mental health disorders that commonly affect children and young people. In the most extreme cases of PRS/PAWS, young people may be unable to perform activities of daily living and rely on adults for physical and emotional support. CD can present as loss of sensation in vision and touch, pain in certain areas and an inability to walk. It is important that children's nurses are aware of these disorders and have some insight into the most helpful approaches. Young people need to feel that their experiences are validated, which can elicit feelings in staff from an urge to help to intense frustration. It is essential for staff to be able to talk and reflect to allow such feelings to be understood. Although these are rare conditions, this article outlines what to do if young people present with features of PRS/PAWS or CD in a general healthcare setting.
Subject(s)
Conversion Disorder/nursing , Nurse-Patient Relations , Pediatric Nursing , Attitude of Health Personnel , Humans , Mental Disorders/nursing , Rare Diseases/nursingABSTRACT
BACKGROUND: Patients with conversion symptoms on neurology wards often report negative interactions with nursing staff. OBJECTIVE/METHOD: The authors therefore systematically studied, by means of an anonymous questionnaire, the attitudes of neuroscience nurses (N=68) toward these patients. RESULTS: Negative attitudes were common: 16% disagreed that conversion symptoms were "real;" 46% thought the patients were "manipulative;" and 34% disagreed that neurology was "an appropriate place" for these patients. Levels of self-perceived knowledge were low. CONCLUSION: These negative attitudes toward patients are likely to impair effective management. Illness beliefs of patients with conversion symptoms need to be understood in the context of the beliefs of the health professionals looking after them.
Subject(s)
Attitude of Health Personnel , Conversion Disorder/nursing , Nursing Staff, Hospital/psychology , Conversion Disorder/psychology , Humans , Nurse-Patient Relations , Surveys and QuestionnairesABSTRACT
Conversion disorder is rare, but when it affects a young woman on the verge of adulthood, it can be devastating. The intent of this article is to encourage others by describing the success that psychiatry and alternative medicine can offer to patients with conversion disorder and to emphasize the value of nursing as a part of that team. This article will explore the attitude change in both staff and patient that was needed to achieve the ultimate goal of wellness.
Subject(s)
Conversion Disorder/therapy , Holistic Nursing , Adult , Cognitive Behavioral Therapy , Complementary Therapies , Conversion Disorder/epidemiology , Conversion Disorder/nursing , Conversion Disorder/psychology , Female , Humans , Incidence , Nurse-Patient Relations , PrevalenceABSTRACT
Hysteria/conversion disorder has been described since antiquity. One French neurologist dubbed it "neurological nonsense" because its presentation was so complex and confusing. For nosological purposes for inclusion into the Diagnostic Statistical Manual, multiple revisions of conversion disorder terminology were made for each edition published from 1952-1994. Until recently, conversion disorder was thought to be solely psychological in origin: new studies raise the possibility that what is called conversion disorder is actually early disruption in the functioning of the nervous system in predisposed individuals. Because of its uncanny resemblance to neurological disease, the differential diagnosis is critical and should be exhaustive in its efforts to rule out neurological disease. The neuroscience nurse needs to be aware of this perplexing syndrome called conversion disorder and the never theories that suggest organic causation and interventions to enhance recovery.
Subject(s)
Conversion Disorder/diagnosis , Nervous System Diseases/diagnosis , Conversion Disorder/nursing , Diagnosis, Differential , Humans , Nervous System Diseases/nursing , Neurologic Examination , Nursing DiagnosisSubject(s)
Conversion Disorder/nursing , Patient Education as Topic , Psychophysiologic Disorders/nursing , Seizures/nursing , Adaptation, Psychological , Conversion Disorder/psychology , Humans , Patient Care Team , Professional-Family Relations , Psychophysiologic Disorders/psychology , Seizures/psychology , Sick RoleABSTRACT
Conversion Disorders involve the psychogenic loss or disturbance of sensory, motor or other physical functions in a manner suggestive of neurologic or other somatic disease but without any actual finding of the latter. These problems are subconscious, with patients not being able to control their symptoms. Jean-Marie Charcot, in the 19th century, was fascinated with this disorder and his work, followed by that of Sigmund Freud, laid the foundation for our modern concept of Conversion Disorder. Multiple Sclerosis, with its fluctuating and unpredictable symptoms has frequently been erroneously diagnosed in these cases. The often bizarre, flamboyant presentations, while interesting, pose many difficult and complex management problems. This paper will describe three of the more severe and disabled examples of this condition seen in the London Multiple Sclerosis Clinic and an attempt will be made to uncover common patient characteristics. Current thoughts regarding the management of these patients will be outlined, the emphasis being on helping neuroscience nurses develop an approach which is informed, positive and compassionate.
