Decision-making of vestibular schwannoma patients.
BACKGROUND
Patients suffering from vestibular schwannoma can choose between four modalities of management: (1) wait-and-scan, (2) tumour resection, (3) radiosurgery and (4) fractionated radiotherapy.


METHODS
This study is based on postal questionnaire survey of 739 vestibular schwannoma patients (survey response rate, 78%). It not only investigates the decision-making of patients, especially the medical consultation, but also further influences on the therapy decision and the patients' evaluation of possible side-effects of the treatment.


RESULTS
Only a minority of the patients was informed about radiosurgery and radiotherapy at all.


CONCLUSIONS
The praxis of patient counselling of acoustic neuroma patients in Germany is far from the ideal condition of medical consultation: The most important shortcoming is that it is unilateral: About 69% of the patients are informed about only one treatment option, generally surgery. Furthermore, information about side effects is usually insufficient. We recommend to advice all patients on all treatment options by an interdisciplinary team. The counselling should firstly be based on evidence-based medicine and secondly respond to the patients' individual life situation and preferences.
Müller
Sabine
S
Division of Medical Psychology, Department of Psychiatry and Psychotherapy, University Hospital Bonn, Sigmund-Freud-Strasse 25, 53105 Bonn, Germany. sabine.mueller3@ukb.uni-bonn.de
Arnolds
Judith
J
van Oosterhout
Ansel
A
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003299:Cooperative Behavior; D003657:Decision Making / Q000941:ethics; D019583:Dose Fractionation, Radiation; D004992:Ethics, Medical; D019317:Evidence-Based Medicine / Q000941:ethics; D005260:Female; D005858:Germany; D006801:Humans; D007258:Informed Consent / Q000941:ethics; D033183:Interdisciplinary Communication; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000532:radiotherapy* / Q000601:surgery*; D010348:Patient Care Team / Q000941:ethics; D010353:Patient Education as Topic / Q000941:ethics; D010358:Patient Participation; D011183:Postoperative Complications / Q000209:etiology; D016634:Radiosurgery / Q000941:ethics; D012189:Retrospective Studies; D055815:Young Adult