Abstracts

Rationale: Psychogenic nonepileptic seizures (PNES) belong to the most challenging medical conditions for the following reasons: i) The pathophysiology is not well understood. ii) Medical experts diagnose people with PNES (PW-PNES) per exclusion. iii) The health care system is not set up appropriately to deal with PW-PNES. iv) The prognosis is less favorable when the diagnosis is delayed. v) An early clear communication of the diagnosis is critical for a good outcome. We applied for the first time a communication tool in a health care setting with PW-PNES, which has been successfully used in several other industries. Methods: Document engineering (DE) is a new methodology developed by CAT-i (Communication and Training International, Calgary, Alberta) strictly following behavioral and brain research. It measurably reduces comprehension and performance errors in users particularly when working under pressure (www.usabilitymapping.com). DE is well established in the oil- and heavy tool industry, but not in health care.  We developed a 1-page patient guide using DE, summarizing the key features of PNES. Results: We conceptualized a 7-domaine-information sheet (7-DIS), which strictly followed the behavioral research based perception-selection-response methodology resulting into a promise-question-answer (PQA) format. Information was kept poignant, easy-to-read and integrating cognitive linking.  7-DIS was presented in a pilot group experiment to PW-PNES. All expressed significant improvement in understanding their disease. Conclusions: PW-PNES often feel entirely lost in the health care system and have difficulties in understanding their diagnosis. A promising new tool is introduced which seems to immediately improve guidance and “navigating” this complex disease. Funding: There is no funding involved in this study.