Patients' perceptions of awake and outpatient craniotomy for brain tumor: a qualitative study.
OBJECTIVE
Routine and nonselective use of awake and outpatient craniotomy for supratentorial tumors has been shown to be safe and effective from a medical standpoint. In this study the authors aim was to explore patients' perceptions about awake and outpatient craniotomy.


METHODS
Qualitative research methodology was used. Two semistructured, open-ended interviews were conducted with 27 participants, who were ambulatory adult patients who underwent craniotomy for brain tumor excision between October 2008 and April 2009. The participants were each assigned to one of the following categories: 1) awake outpatient; 2) awake inpatient; 3) outpatient under general anesthesia; and 4) inpatient under general anesthesia. Interviews were audiotaped and transcribed, and the data were subjected to thematic analysis.


RESULTS
The following 6 overarching themes emerged from the data: 1) patients had a positive experience with awake craniotomy; 2) patient satisfaction with outpatient surgery was high; 3) patients understood the rationale behind awake surgery; 4) patients were surprised that brain surgery can be done on an outpatient basis; 5) trust in one's surgeon was important; and 6) patients were more concerned about the disease than the procedure.


CONCLUSIONS
The results reflected positively on the patients' awake and outpatient surgery experience, but there were some areas that require improvement, specifically perioperative pain control and postoperative care. These insights on patients' perspectives can lead to better delivery of care, and ultimately, improved health outcomes.
Khu
Kathleen Joy
KJ
Division of Neurosurgery, Toronto Western Hospital, University of Toronto, Ontario, Canada.
Doglietto
Francesco
F
Radovanovic
Ivan
I
Taleb
Faisal
F
Mendelsohn
Daniel
D
Zadeh
Gelareh
G
Bernstein
Mark
M
D000328:Adult; D000368:Aged; D000553:Ambulatory Care; D001294:Attitude to Health; D001932:Brain Neoplasms / Q000601:surgery*; D003399:Craniotomy; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010361:Patients; D011300:Preoperative Care; D014851:Wakefulness