Kranenburg Leonieke W, van Ark Tom, van Haren Mathijs M J, Schouten Joost W, Busschbach Jan J, Klimek Markus
Department of Psychiatry, Erasmus MC, Rotterdam, The Netherlands.
Department of Anesthesiology, Erasmus MC, Rotterdam, The Netherlands.
Neurooncol Pract. 2024 Nov 6;12(2):333-339. doi: 10.1093/nop/npae111. eCollection 2025 Apr.
The diagnosis and awake removal of a brain tumor is a major life event. A better understanding of the needs of this group of patients and their primary contacts in the perioperative trajectory can further improve care.
Adult patients who underwent an awake craniotomy (AC) in the Erasmus MC, the Netherlands and their primary contacts were interviewed 1-2 weeks prior to surgery and 2-4 weeks after surgery. Semi-structured interviews on the impact of the diagnosis on their lives and coping mechanisms with the AC procedure were conducted. Interview transcripts were analyzed in accordance with the principles of grounded theory.
Twenty-one patients and 19 primary contacts were interviewed at least once during this period. Analyses and coding of the transcripts resulted in a conceptual model, distinguishing coping with the disease and coping with specific procedures of AC. In general, participants tended to rely on their pre-existing ways of coping. Situation-specific coping mostly refers to perceiving control, and related to that, trust in the medical team.
Patients with a brain tumor and their primary contacts perceive coping with the AC procedure as a part of coping with the disease. Although the procedure may be perceived as stressful, at the same time it offers hope and prospect. In coping with the specifics of the AC procedure, we found that feeling in control and as an extension of that, trust in the AC team were key aspects.
脑肿瘤的诊断及在清醒状态下切除是一件重大的人生事件。更好地了解这类患者及其主要联系人在围手术期的需求,能够进一步改善护理。
对在荷兰伊拉斯姆斯医学中心接受清醒开颅手术(AC)的成年患者及其主要联系人,在手术前1 - 2周和手术后2 - 4周进行访谈。就诊断对其生活的影响以及应对AC手术的机制进行半结构化访谈。访谈记录依据扎根理论原则进行分析。
在此期间,21名患者和19名主要联系人至少接受了一次访谈。对访谈记录的分析和编码得出一个概念模型,区分了应对疾病和应对AC特定手术过程。总体而言,参与者倾向于依赖其原有的应对方式。特定情境下的应对主要指感知控制,与此相关的是对医疗团队的信任。
脑肿瘤患者及其主要联系人将应对AC手术视为应对疾病的一部分。尽管该手术可能被视为有压力,但同时它也带来了希望和前景。在应对AC手术的具体情况时,我们发现感觉能掌控局面以及作为其延伸的对AC团队的信任是关键方面。