Patient-reported factors that influence the vestibular schwannoma treatment decision: a qualitative study

O M Neve; G Soulier; M Hendriksma; A G L van der Mey; A van Linge; P P G van Benthem; E F Hensen; A M Stiggelbout

doi:10.1007/s00405-020-06401-0

Patient-reported factors that influence the vestibular schwannoma treatment decision: a qualitative study

Eur Arch Otorhinolaryngol. 2021 Sep;278(9):3237-3244. doi: 10.1007/s00405-020-06401-0. Epub 2020 Oct 7.

Authors

O M Neve¹, G Soulier², M Hendriksma², A G L van der Mey², A van Linge³, P P G van Benthem², E F Hensen², A M Stiggelbout⁴

Affiliations

¹ Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands. o.m.neve@lumc.nl.
² Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands.
³ Department of Otorhinolaryngology and Head and Neck Surgery, Erasmus Medical Center, Rotterdam, The Netherlands.
⁴ Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.

Abstract

Purpose: In cases of small- to medium-sized vestibular schwannomas, three management strategies can be opted for: active surveillance, surgery or radiotherapy. In these cases, the patient's preference is pivotal in decision-making. The aim of this study was to identify factors that influence a patient's decision for a particular management strategy.

Methods: A qualitative inductive thematic analysis was performed based on semi-structured interviews. Eighteen patients with small- to medium-sized vestibular schwannomas were interviewed. All patients were diagnosed or treated at one of the two participating university medical centers in the Netherlands.

Results: Ten themes were identified that influenced the decision, classified as either medical or patient-related. The medical themes that emerged were: tumor characteristics, the physician's recommendation, treatment outcomes and the perceived center's experience. The patient-related themes were: personal characteristics, anxiety, experiences, cognitions, logistics and trust in the physician.

Conclusion: Knowledge of the factors that influence decision-making helps physicians to tailor their consultations to arrive at a true shared decision on vestibular schwannoma management.

Keywords: Patient-centered care; Qualitative research; Shared decision-making; Vestibular schwannoma.

MeSH terms

Decision Making
Humans
Netherlands
Neurilemmoma*
Neuroma, Acoustic* / therapy
Patient Reported Outcome Measures
Qualitative Research