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Maier AD, Nordentoft S, Mathiesen T, Guldager R. The experience of living with malignant meningioma. Palliat Support Care 2024; 22:338-346. [PMID: 37221880 DOI: 10.1017/s1478951523000585] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/25/2023]
Abstract
OBJECTIVES Meningiomas are the most common, primary intracranial tumor and most are benign. Little is known of the rare patient group living with a malignant meningioma, comprising 1-3% of all meningiomas. Our aim was to explore how patients perceived quality of daily life after a malignant meningioma diagnosis. METHODS This qualitative explorative study was composed of individual semi-structured interviews. Eligible patients (n = 12) were selected based on ability to participate in an interview, from a background population of 23 patients diagnosed with malignant meningioma at Rigshospitalet from 2000 to 2021. We performed an inductive thematic analysis following Braun and Clarke's guidelines. RESULTS Eight patients were interviewed. The analysis revealed 4 overarching themes: (1) perceived illness and cause of symptoms, (2) identity, roles, and interaction, (3) threat and uncertainty of the future, and (4) belief in authority. The perceived quality of daily life is negatively impacted by the disease. Patients experience a shift in self-concept and close interactions, and some struggle with accepting a new everyday life. Patients have a high risk of discordant prognostic awareness in relation to health-care professionals. SIGNIFICANCE OF RESULTS We provide a much-needed patient-centered perspective of living with malignant meningioma: quality of life was affected by perception of threat and an uncertainty of the future. Perception of illness and the interpretation of the cause of symptoms varied between subjects, but a common trait was that patients' identity, roles, and interactions were affected. Shared decision-making and a strengthened continuity during follow-up could aid this rare patient group.
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Affiliation(s)
- Andrea Daniela Maier
- Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Pathology, Copenhagen University Hospital, Copenhagen, Denmark
| | - Sara Nordentoft
- Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark
| | - Tiit Mathiesen
- Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark
- Department of Clinical Medicine, University of Copenhagen, Copenhagen, Denmark
- Department of Clinical Neuroscience, Karolinska Institutet, Stockholm, Sweden
| | - Rikke Guldager
- Department of Neurosurgery, Copenhagen University Hospital, Copenhagen, Denmark
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Nowacka A, Barker-Collo S, Miles A. Exploring the influence of appearance evaluation apprehension: How fear of negative evaluation affects quality of life in people with Vestibular Schwannoma. J Clin Neurosci 2024; 123:7-12. [PMID: 38508019 DOI: 10.1016/j.jocn.2024.03.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 03/12/2024] [Accepted: 03/14/2024] [Indexed: 03/22/2024]
Abstract
People diagnosed with Vestibular Schwannoma (VS) can experience several symptoms both pre and post-treatment. These, alongside the diagnosis experience, can significantly impact their daily life. The present research is a continuation of a larger study aiming to explore the impacts of symptomology and body image/fear of negative evaluation (FNAE) on the quality of life (QOL) for people with VS. The research design was exploratory and involved a nationwide survey with a total of 52 participants. FNAE was assessed using a measurement of the same name, and QOL was assessed using the Penn Acoustic Neuroma Quality of Life scale (PANQOL). Comparing management groups revealed a significant difference in FNAE with higher scores for surgery compared to radiation treatment. Regression analyses revealed that FNAE significantly accounted for 10.9% of the variance in QOL. However, no symptom was significantly predictive of FNAE. In conclusion, VS is associated with several symptoms that can persist post-treatment. Body satisfaction contributes to QOL and may differ between management types. However, due to inconclusive findings on the predictability of symptoms on FNAE, other moderator factors could influence these direct relationships. Future studies should evaluate the variables that could mitigate or protect from the impacts of FNAE for this population.
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Affiliation(s)
- Alicja Nowacka
- School of Psychology, The University of Auckland, Auckland, New Zealand.
| | - Suzanne Barker-Collo
- Clinical Training Programme, School of Psychology, The University of Auckland, Auckland, New Zealand
| | - Anna Miles
- Speech Science, School of Psychology, The University of Auckland, Auckland, New Zealand
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Ben-Harosh L, Barker-Collo S, Nowacka A, Garrett J, Miles A. Quality of life and broader experiences of those with acoustic neuroma: a mixed methods approach. BRAIN IMPAIR 2024; 25:IB23072. [PMID: 38566292 DOI: 10.1071/ib23072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2023] [Accepted: 10/04/2023] [Indexed: 04/04/2024]
Abstract
Background Acoustic neuromas (ANs) are consistently associated with decreased quality of life (QOL) related to the physical and psychosocial impacts of symptoms experienced from the tumour and its treatment. This study explored patient-reported experiences of ANs in New Zealand, with a focus on the impact on QOL and the provision of information, support and services. Methods A mixed methods approach was taken, conducting an online community survey that included the Penn Acoustic Neuroma Quality of Life Scale (N = 52). Those who indicated interest were offered semi-structured interviews after the survey (N = 17), which were analysed using content analysis. Results A negative impact on QOL was found, highlighting five key themes in the experiences of people: (1) ongoing physical, social and psychological impacts; (2) information and support from the medical system; (3) autonomy and decision-making; (4) the importance of peer support; and (5) remaining positive - life goes on. Conclusions Our findings indicate areas for improvement that may benefit people's healthcare experience and QOL. Both quantitative and qualitative results identified gaps associated with person-centred care and the need for information, education, emotional support and access to services. Recommendations include a need for more information (verbal and written) during all stages of diagnosis and treatment, shared decision-making and increased access to allied health, including psychological services and support groups.
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Affiliation(s)
- Lior Ben-Harosh
- School of Psychology, The University of Auckland, New Zealand
| | | | - Alicja Nowacka
- School of Psychology, The University of Auckland, New Zealand
| | - Joanne Garrett
- School of Psychology, The University of Auckland, New Zealand
| | - Anna Miles
- School of Psychology, The University of Auckland, New Zealand
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Maier AD. Malignant meningioma. APMIS 2022; 130 Suppl 145:1-58. [DOI: 10.1111/apm.13276] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- Andrea Daniela Maier
- Department of Neurosurgery, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
- Department of Pathology, Rigshospitalet Copenhagen University Hospital Copenhagen Denmark
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Health-Related Quality of Life and Return to Work after Surgery for Spinal Meningioma: A Population-Based Cohort Study. Cancers (Basel) 2021; 13:cancers13246371. [PMID: 34944991 PMCID: PMC8699140 DOI: 10.3390/cancers13246371] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 12/08/2021] [Accepted: 12/16/2021] [Indexed: 12/15/2022] Open
Abstract
Simple Summary Spinal meningioma is the most common primary intradural spinal tumor. Although histologically benign, the tumors often cause neurological deficits. Health-related quality of life (HRQoL) is defined as the aspects of quality of life which are most affected by ill health and is a measure of self-perceived health status. Despite many studies evaluating the neurological outcome after surgery for spinal meningiomas, no study has been concerned with the HRQoL and frequency of return to work. In this population-based cohort study, we reviewed 84 cases of surgically treated spinal meningiomas, with a mean follow-up of 8.7 years, to assess their HRQoL compared to a sample of the general population. We found that HRQoL after surgery was equal to the normal population, and the frequency of return to work was 100%, often within three months of surgery. Thus, surgical treatment of spinal meningiomas should not be considered a threat to long-term quality of life. Abstract Spinal meningiomas are the most common primary spinal intradural tumor. This study aimed to assess Health-related quality of life (HRQoL) and the frequency of return to work in patients surgically treated for spinal meningiomas, in comparison to the general population. Variables were collected from patient charts, EQ-5D-3L, and study specific questionnaires. Patients who had been operated between 2005–2017 were identified in a previous study and those alive in 2020 (104 of 129) were asked to participate. Eighty-four patients (80.8%) with a mean follow-up of 8.7 years, responded and were included. Data was compared to the Stockholm Public Health Survey 2006, a cross-sectional survey of a representative sample of the general population. Analysis for potential non-response bias showed no significant differences. Women in the meningioma sample scored more problems than men with regards to mobility (p = 0.048). There were no significant differences concerning EQ-5Dindex (p = 0.325) or EQVAS (p = 0.116). The correlation between follow-up time and EQ-5Dindex was low (r = 0.167). When comparing HRQoL to the general population sample, no significant differences were found within the EQ-5D-3L dimensions, EQ-5Dindex or EQVAS. Those who postoperatively scored 3–5 on mMCs scored significantly more problems in the EQ-5D-3L dimension mobility (p = 0.023). Before surgery, 41 (48.8%) of the spinal meningioma patients were working and after surgery all returned to work, the majority within three months. Seventy-eight (96%) of the patients would accept surgery for the same diagnosis if asked today. We conclude that surgery for spinal meningiomas is associated with good long-term HRQoL and a high frequency of return to work.
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Hoffmann K, Kamp M, Steiger HJ, Sabel M, Rapp M. Correlation of psychooncological distress- screening and quality of life assessment in neurosurgical patients. Oncotarget 2017; 8:111396-111404. [PMID: 29340062 PMCID: PMC5762330 DOI: 10.18632/oncotarget.22802] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/05/2017] [Accepted: 10/27/2017] [Indexed: 12/25/2022] Open
Abstract
Background Cerebral tumors are associated with high rates of anxiety, depression and reduced health related quality of life. But still psychooncological screening instruments are not implemented in the daily routine of neurosurgical departments. In contrast the EORTC QLQ-C30/ EORTC QLQ- BN20 questionnaire is often used to evaluate quality of life in the framework of clinical studies. We were therefore interested, if conspicuous distress screening results are also reflected by HRQOL assessment. Patients and Methods Patients who were electively admitted for surgery of intracranial lesions were screened for their psychooncological distress using two self-assessment instruments (Hospital Anxiety and Depression Scale (HADS) and Distress Thermometer (DT)) and one external assessment questionnaire (Psychooncological base documentation (PO-Bado). Results were correlated with three subscales of the EORTC-QLQ-C30 and EORTC-QLQ-BN20 questionnaire. Results From October 2013 to March 2015, 594 patients were admitted for elective cranial neurosurgical procedure. 489 neurosurgical patients were screened for increased distress. Data from 450 patients could be correlated with the EORTC-QLQ-C30 and EORTC-QLQ-BN20. In 265 patients screening revealed increased distress. A concurrent reduced global health /higher rates of future uncertainty and conspicuous distress screening results are found in 173 patients (69.5%) compared to 30.5% of patients (n= 76) with unremarkable screening. Increased distress screening was highly significant with increased level of future uncertainty as well as decreased level of quality of life and global health (p<0.0001). Conclusion Psychooncological distress is accompanied by reduced quality of life, global heath and increased future uncertainty. Therefore HQOL assessment can be helpful identifying patients with increased distress.
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Affiliation(s)
- Kira Hoffmann
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Marcel Kamp
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Hans-Jakob Steiger
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Michael Sabel
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
| | - Marion Rapp
- Department of Neurosurgery, Medical Faculty, Heinrich-Heine-University, Duesseldorf, Germany
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Cubis L, Ownsworth T, Pinkham MB, Chambers S. The social trajectory of brain tumor: a qualitative metasynthesis. Disabil Rehabil 2017; 40:1857-1869. [PMID: 28420297 DOI: 10.1080/09638288.2017.1315183] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
Abstract
PURPOSE Research indicates that strong social ties can buffer the adverse effects of chronic illness on psychological well-being. Brain tumor typically leads to serious functional impairments that affect relationships and reduce social participation. This metasynthesis aimed to identify, appraise and integrate the findings of qualitative studies that reveal the impact of brain tumor on social networks. METHODS Four major databases (PubMed, CINAHL, Cochrane Library and PsycINFO) were systematically searched from inception to September 2016 for qualitative studies that reported findings on the impact of primary brain tumor on social networks during adulthood. Twenty-one eligible studies were identified and appraised according to the Consolidated Criteria for Reporting Qualitative Research. Key findings of these studies were integrated to form superordinate themes. RESULTS The metasynthesis revealed the core themes of: 1) Life disrupted; 2) Navigating the new reality of life; and 3) Social survivorship versus separation. CONCLUSIONS Multiple changes typically occur across the social trajectory of brain tumor, including a loss of pre-illness networks and the emergence of new ones. Understanding the barriers and facilitators for maintaining social connection may guide interventions for strengthening social networks and enhancing well-being in the context of brain tumor. Implications for rehabilitation Social networks and roles are disrupted throughout the entire trajectory of living with brain tumor Physical, cognitive and psychological factors represent barriers to social integration Barriers to social integration may be addressed by supportive care interventions Compensatory strategies, adjusting goals and expectations, educating friends and family and accepting support from others facilitate social reintegration throughout the trajectory of living with brain tumor.
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Affiliation(s)
- Lee Cubis
- a School of Applied Psychology , Menzies Health Institute Queensland, Griffith University , Mt Gravatt , Australia
| | - Tamara Ownsworth
- a School of Applied Psychology , Menzies Health Institute Queensland, Griffith University , Mt Gravatt , Australia
| | - Mark B Pinkham
- b Princess Alexandra Hospital , University of Queensland , Woolloongabba , Australia
| | - Suzanne Chambers
- c Menzies Health Institute , Queensland , Nathan , Australia.,d Cancer Council Queensland , Brisbane , Australia
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Krogsgaard M, Dreyer P, Egerod I, Jarden M. Post-discharge symptoms following fast-track colonic cancer surgery: a phenomenological hermeneutic study. SPRINGERPLUS 2014; 3:276. [PMID: 24936395 PMCID: PMC4053570 DOI: 10.1186/2193-1801-3-276] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 01/02/2014] [Accepted: 05/13/2014] [Indexed: 12/20/2022]
Abstract
OBJECTIVE To obtain knowledge of patients' experiences of postoperative symptoms during the initial two weeks following fast-track colonic cancer surgery. METHOD Semi-structured in-depth interviews with seven colonic cancer patients two weeks post hospital discharge. Analysis was performed using a phenomenological hermeneutical approach. RESULTS During the first two weeks after discharge the patients experienced unfamiliar symptoms that affected their everyday lives. Despite distressing symptoms, they applied a "wait-and-see" strategy, and only reacted when symptoms became intolerable. The patients failed to report their unfamiliar symptoms during hospital nurse follow-up telephone call. While waiting for the final histology patients suffered loss of sleep and chaotic thinking, and experienced ambiguity of hoping for the best and expecting the worst. CONCLUSION Although fast-track surgery programmes lead to shorter hospitalisation and improved physical performance, post-colonic surgery patients experience various symptoms after discharge. Healthcare professionals need to address symptoms that might have immediate and long-term consequences on patients' everyday life. Follow-up studies are encouraged to explore the patient perspective to identify the needs of individual patients after hospital discharge.
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Affiliation(s)
- Marianne Krogsgaard
- Digestive Disease Center, Bispebjerg Hospital, Copenhagen University Hospital, Bispebjerg Bakke 23, DK-2400 Copenhagen, NV, Denmark
| | - Pia Dreyer
- Faculty of Health, Aarhus University, Noerrebrogade 44, building 21,1, DK-8000 Aarhus, Denmark ; Department of Anesthesia and intensive Care Medicine, Aarhus University Hospital, Noerrebrogade 44, building 21,1, DK-8000 Aarhus, Denmark
| | - Ingrid Egerod
- Faculty of Health and Medical Sciences, University of Copenhagen, Blegdamsvej 9, DK-2100 Copenhagen, Denmark ; Copenhagen University Hospital Rigshospitalet, Trauma Centre, Blegdamsvej 9, DK-2100 Copenhagen, Denmark
| | - Mary Jarden
- The University Hospitals Centre for Health Research, Rigshospitalet, Ryesgade 27, DK-2200 Copenhagen, N, Denmark
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