Exploring the experiences and challenges for patients undergoing cranioplasty: a mixed-methods study protocol

Harry Mee; Clare Clement; Fahim Anwar; Gemma Whiting; Ivan Timofeev; Adel Helmy; Peter John Hutchinson; Angelos G Kolias

doi:10.1136/bmjopen-2020-048072

Exploring the experiences and challenges for patients undergoing cranioplasty: a mixed-methods study protocol

BMJ Open. 2022 Apr 22;12(4):e048072. doi: 10.1136/bmjopen-2020-048072.

Authors

Harry Mee^{1

2}, Clare Clement³, Fahim Anwar⁴, Gemma Whiting², Ivan Timofeev², Adel Helmy², Peter John Hutchinson², Angelos G Kolias²

Affiliations

¹ Division of Rehabilitation Medicine, Department of Clinical Neurosciences, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK hwjm2@cam.ac.uk.
² Division of Neurosurgery, Department of Clinical Neurosciences, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.
³ School of Social and Community Medicine, Bristol Trials Centre, University of Bristol, Bristol, UK.
⁴ Division of Rehabilitation Medicine, Department of Clinical Neurosciences, University of Cambridge and Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK.

Abstract

Introduction: Cranioplasty is a widely practised neurosurgical procedure aimed at reconstructing a skull defect, but its impact on a patient's rehabilitation following a traumatic brain injury (TBI) or stroke could be better understood. In addition, there are many issues that a TBI patient or the patient who had a stroke and their families may have to adapt to. Insight into some of the potential social barriers, including issues related to social engagement and cosmetic considerations, would be beneficial. Currently, little is known about how this procedure impacts a patient's recovery, the patient's perceptions of rehabilitation precranioplasty and postcranioplasty and the broader issues of cosmesis and social reintegration. This study hopes to understand some of these issues and therefore help inform clinicians of some of the difficulties and perceptions that patients and their relatives may have.

Methods and analysis: A mixed-methods study. Data will be collected through focus groups with healthcare professionals (HCPs) and semi-structured interviews with patients and their relatives, field notes, a researcher diary and a patient questionnaire. Different perspectives will be brought together through method triangulation. Patient and relative data will be analysed using interpretive phenomenological analysis, and HCPs data will be analysed thematically using deductive and inductive coding.

Ethics and dissemination: Ethical approval has been obtained from the Wales REC 7 ethics committee (Rec ref: 19/WA/0315). There is limited literature regarding a patient's perception of the cranioplasty process, the potential impact on rehabilitation and how this may impact their reintegration into the community. The results of this study will be presented at national brain injury conferences and published in peer-reviewed, national and international journals.

Keywords: neurological injury; neurosurgery; qualitative research; rehabilitation medicine; stroke.

Publication types

Research Support, Non-U.S. Gov't

MeSH terms

Brain Injuries, Traumatic* / surgery
Health Personnel
Humans
Research Design
Skull
Stroke*