title: The art of perception: Patients drawing their vestibular schwannoma.
abstract: OBJECTIVE
  Drawings made by patients are an innovative way to assess the perceptions of patients on their illness. The objective of this study, at a university tertiary referral center, on patients who have recently been diagnosed with vestibular schwannoma, was to examine whether patients' illness perceptions can be assessed by drawings and are related to their quality of life.
  
  
  METHODS
  Cross-sectional study.
  
  
  METHODS
  Patients diagnosed with vestibular schwannoma (mean age [range], 55.4 [17-85] years) between April 2011 and October 2012 were included (N = 253). Sociodemographics, illness perceptions (Brief Illness Perception Questionnaire [B-IPQ]), and disease-specific quality of life (Penn Acoustic Neuroma Quality of Life [PANQOL] scale) were assessed to evaluate the impact of being diagnosed with vestibular schwannoma. Furthermore, patients' drawings of their tumor were analyzed to explore the association between illness perceptions, drawings, and quality of life.
  
  
  RESULTS
  Comparison of the B-IPQ scores of the current sample (N = 139; response rate 54.9%) with other disease samples shows a significantly lower score for patients with vestibular schwannoma on the Coherence dimension, indicating a low understanding of the illness. Illustration of emotions (N = 12) in the drawings gave a negative association with quality of life. Intercorrelations indicate a positive association between a low amount of physical and emotional consequences of the illness and a higher score on the Balance, Hearing, and Energy dimensions of the PANQOL.
  
  
  CONCLUSIONS
  Patients' drawings give an insight into their perception of the tumor inside their head. Use of drawings may be helpful when developing and offering self-management programs. Quality of life appears to be significantly affected by the diagnosis.
  
  
  METHODS
  4.
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Bibian M
authors.initials: BM
authors.lastname: van Leeuwen
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Jasmijn M
authors.initials: JM
authors.lastname: Herruer
authors.affiliation: Department of Medical Statistics, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Hein
authors.initials: H
authors.lastname: Putter
authors.affiliation: Department of Otorhinolaryngology-Head and Neck Surgery, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Andel G L
authors.initials: AG
authors.lastname: van der Mey
authors.affiliation: Department of Medical Psychology, Leiden University Medical Center, Leiden, the Netherlands.
authors.forename: Adrian A
authors.initials: AA
authors.lastname: Kaptein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003430:Cross-Sectional Studies; D004644:Emotions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009464:Neuroma, Acoustic / Q000523:psychology*; D010151:Paintings; D010465:Perception; D011788:Quality of Life; D012647:Self-Assessment; D055815:Young Adult
keywords: Brief Illness Perception Questionnaire; Penn Acoustic Neuroma Quality of Life scale; Vestibular schwannoma; illness perceptions; patients’ drawings; quality of life; self-management