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Updated: May 21, 2025
Translational Brain Mapping at the University of Rochester Medical Center: Preserving the Mind Through Personalized Brain Mapping
Published on: August 12, 2019
A thematic analysis of shared decision-making in consultations with patients with a presumed brain tumor and
Iris J M Bras1,2, Margot C W Joosen3, Geert-Jan M Rutten1
1Department of Neurosurgery, Elisabeth-TweeSteden Hospital, Tilburg, The Netherlands.
Background:
Patients with brain tumors, family members, and healthcare professionals face complex healthcare decisions that can significantly impact everyday life. Engaging in shared decision-making (SDM) can help ensure treatment decisions align with patients' preferences and goals. Little is known about the decision-making process in neurosurgical consultations. This study aims to qualitatively explore and describe the SDM process during neurosurgical consultations for patients with a presumed brain tumor.
Methods:
The first consultation between patients with presumed glioma or meningioma and their neurosurgeons was audio-recorded and transcribed. Decision-making models were used as sensitization concepts, with coding carried out inductively. We employed a reflexive thematic analysis to develop themes and subthemes until saturation was beginning to emerge.
Results:
Analyzing eleven consultations, we developed three main themes and twelve subthemes. The results depict decision-making guided by neurosurgeons (theme 1), with varying degrees of engagement from patients and family members (theme 2) and personalization of the decision-making process based on the medical situation and everyday life priorities (theme 3). The consultations lacked specific attention to the everyday life priorities of the patients.
Conclusions:
The decision-making processes seemed to focus primarily on medically informing patients with a presumed brain tumor, in line with informed decision-making. However, less emphasis was placed on learning more about the patient's everyday life and preferences to integrate into the decision-making process, which is key to SDM. Incorporating patient goals may lead to greater personalization and decisions that align with both the patient's medical situation and their goals.
