Healthcare professionals' perspectives on barriers and facilitators to managing brain tumor-related personality and...

This study aimed to identify healthcare professionals' perceptions of the facilitators and barriers impacting the management of brain tumor-related personality and behavior changes in adults.

We conducted semi-structured interviews with neuro-oncology healthcare professionals' working in Australia (N = 22). Interview recordings were transcribed, and codebook thematic analysis methods applied.

Two themes identified as barriers in managing brain tumor-related personality changes were (1) Systemic challenges, with two sub themes of "fall between the gaps" and waitlist and unavailability of services and (2) patient and carer factors, comprising three sub-themes of "evolving injury," complexities of non-disclosure, and attitudes toward help seeking. Two themes identified as facilitators were (1) systemic supports for healthcare professionals encompassing three sub-themes; stepped care model, multidisciplinary team approach, and professional development opportunities. The second facilitator theme was (2) infrastructure, with four sub-themes: accessible specialist care with follow-up, up-to-date information resources, carer supports, and Cancer Care Coordinator model.

The findings emphasize the need for improved infrastructure and systemic supports for healthcare professionals to allow for a more integrated approach with routine screening of psychosocial needs including patient personality and behavior changes, timely referrals, and multidisciplinary team care across the disease trajectory. Addressing barriers and promoting facilitators is essential for improving the quality of life for people with brain tumor and reducing the potential for burden on carers related to personality and behavior changes. Results of this study provide a starting point with a proposed stepped-care approach that requires further testing in clinical practice.