Abstract
PurposeIn 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.MethodsA 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.ResultsTen 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.ConclusionKnowledge of the factors that influence decision-making helps physicians to tailor their consultations to arrive at a true shared decision on vestibular schwannoma management.
Highlights
Vestibular schwannoma (VS) is a benign intracranial tumor, arising from schwann cells of the vestibular branch of the vestibulocochlear nerve
Data saturation was reached after 18 interviews
We identified several patient factors influencing the decision between surgery and radiotherapy: the patients’ cognitions, the patients’ experience, logistics and trust in the physician
Summary
Vestibular schwannoma (VS) is a benign intracranial tumor, arising from schwann cells of the vestibular branch of the vestibulocochlear nerve. Current management options for VS generally consist of one of three modalities: microsurgery, radiotherapy or active surveillance ( known as wait-and-scan policy) [1]. Based on the available evidence, a clinical equipoise exists in the management of small- to. European Archives of Oto-Rhino-Laryngology (2021) 278:3237–3244 management [2,3,4]. A four-step model is often used to apply SDM in clinical practice [4]. The physician and patient discuss the patient’s preferences and the physician supports the patient in deliberation. The patient’s decisional role and preference are discussed and the decision is made or deferred. To make this process work satisfactorily, an understanding of the factors that influence patients’ decision are essential
Sign-in/Register to view highlights & summary Sign-in/Register to access full text options 
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
