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"It's Hard!": Adolescents' School Experience and Self-Management of Psychogenic Nonepileptic Seizures

Indiana University-Purdue University Indianapolis (IUPUI) / Adolescents with a type of conversion disorder called psychogenic nonepileptic
seizures (PNES) experience many school, relationship, and health care struggles as they
attempt to manage their mental health condition with PNES events that strikingly
resemble epileptic seizures. Considered one of the top three neuropsychiatric problems,
health care providers and school personnel remain ill-informed regarding how to care for
adolescents with PNES. Because of the unique multidisciplinary approach needed to
address adolescent PNES, school nurses are uniquely positioned to bridge health care and
education systems. A review of literature examined the concept of school nurse selfmanagement
support for PNES, existing school nurse-led mental health interventions,
and the relationships between concepts for a conceptual framework guiding adolescent
PNES research. This review of literature reveals an absence of adolescents’ perspective
and school emphasis in PNES research.
This study was designed to investigate adolescents’ experience attending school
and self-managing PNES. This was accomplished through a qualitative content analysis
of data generated from semi-structured interviews and magnitude coding of select
quantifiable data. Data were obtained from 10 adolescents, 12 to 19 years of age, with
current or recent in-person school attendance. The results indicate adolescents from the
sample had school experiences that involved stress, bullying, accusations of faking
seizures, and feelings of isolation or exclusion. Their mostly effective proactive selfmanagement
activities included seeking protection, persevering in life despite PNES struggles, and progress monitoring through seizure tracking. Reactive activities of mixed
effectiveness included coping responses to seizure warnings. School nurses, school
personnel, family members, and peers served as both facilitators and barriers for PNES
self-management. Adolescents also contributed information for three emerging themes—
family-management, school-management, and illness representation. These findings
reveal the difficulties of attending school and self-managing PNES and inform future
PNES interventions to improve academic, mental health, and quality of life outcomes.

Identiferoai:union.ndltd.org:IUPUI/oai:scholarworks.iupui.edu:1805/26255
Date06 1900
CreatorsTanner, Andrea Lynn
ContributorsMiller, Wendy, Buelow, Janice, von Gaudecker, Jane, Decker, Janet R.
Source SetsIndiana University-Purdue University Indianapolis
Languageen_US
Detected LanguageEnglish
TypeDissertation

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