title: Inadequate communication between patients with unruptured cerebral aneurysms and neurosurgeons.
abstract: Communication between patients with cerebral aneurysms and consulting neurosurgeons remains unstudied in Japan. The present clinical study surveyed patients with unruptured cerebral aneurysms and their neurosurgeons after explanation of the disease and its treatment options and expected outcomes in clinic visits using a one-page written questionnaire about treatment options and decisions given to patients and their neurosurgeons. The numbers of participating patients and neurosurgeons were 42 and 9, respectively, and 42 paired patient-neurosurgeon responses were obtained. Agreement was quite low (κ = 0.17-0.31 for 6-point Likert scale and κ = 0.44-0.67 for 2 category scale) regarding the "best" treatment for each patient as agreed on by the patient and neurosurgeon. Agreement in the understanding of treatment options and general application was unexpectedly low (κ = 0.12 and 0.01 for 6-point Likert scale and κ = not applicable and -0.03, respectively, for 2 category scale). Agreement tended to be higher between experienced neurosurgeons and patients than non-experienced neurosurgeons and patients. Patients estimated much higher risks of stroke or death after surgical intervention (p < 0.001) or no intervention (p = 0.006) compared with the estimates offered by their neurosurgeons.
authors.affiliation: Department of Neurosurgery, Shiga University of Medical Science, Otsu, Shiga.
authors.forename: Makoto
authors.initials: M
authors.lastname: Saito
authors.forename: Yoshimitsu
authors.initials: Y
authors.lastname: Takahashi
authors.forename: Yayoi
authors.initials: Y
authors.lastname: Yoshimura
authors.forename: Ayako
authors.initials: A
authors.lastname: Shima
authors.forename: Akio
authors.initials: A
authors.lastname: Morita
authors.forename: Kiyohiro
authors.initials: K
authors.lastname: Houkin
authors.forename: Takeo
authors.initials: T
authors.lastname: Nakayama
authors.forename: Kazuhiko
authors.initials: K
authors.lastname: Nozaki
mesh_terms: D000328:Adult; D000368:Aged; D003144:Communication Barriers; D032882:Comprehension; D003657:Decision Making; D005260:Female; D057220:Health Literacy; D006801:Humans; D002532:Intracranial Aneurysm / Q000401:mortality / Q000601:surgery*; D007564:Japan; D008297:Male; D008875:Middle Aged; D010353:Patient Education as Topic; D010817:Physician-Patient Relations; D011183:Postoperative Complications / Q000209:etiology / Q000401:mortality; D012017:Referral and Consultation; D018570:Risk Assessment; D020521:Stroke / Q000209:etiology / Q000401:mortality; D011795:Surveys and Questionnaires