TY - JOUR
T1 - Patient Expectations About Palliative Treatment for Symptomatic Spinal Metastases
T2 - A Qualitative Study
AU - Gal, Roxanne
AU - Charest-Morin, Raphäele
AU - Verlaan, Jorrit-Jan
AU - Fisher, Charles G
AU - Wessels, Hester
AU - Verkooijen, Helena M
AU - Versteeg, Anne L
N1 - Funding Information:
Conflict of Interest Disclosures: Dr Gal, Dr Fisher, Prof Verkooijen, and Dr Versteeg reported receiving grants from AOSpine International during the conduct of the study. Dr Charest-Morin reported receiving grants from AOSpine International during the conduct of the study. Prof Verlaan reported receiving grants from DePuy Synthes outside the submitted work and reported stock ownership in Sentryx. Dr Fisher reported receiving consulting fees, royalties, and fellowship support from Medtronic; reported receiving consulting fees from Nuvasive; and reported receiving fellowship support from AOSpine outside the submitted work. No other disclosures were reported.
Funding Information:
Funding/Support: This work was supported by AO Spine International .
Publisher Copyright:
© 2022
PY - 2023/1
Y1 - 2023/1
N2 - OBJECTIVES: Patients with spinal metastases often receive palliative surgery or radiation therapy to maintain or improve health-related quality of life. Patients with unrealistic expectations regarding treatment outcomes have been shown to be less satisfied with their post-treatment health status. This study evaluated expectations of patients with spinal metastases scheduled for surgery and/or radiation therapy.METHODS: Individual semistructured interviews were conducted with patients with symptomatic spinal metastases before and 6 weeks after surgery and/or radiation therapy. Expectations regarding treatment outcomes were discussed before treatment, and level of fulfillment of these pretreatment expectations was discussed after treatment. Interviews were recorded, transcribed and analyzed according to the thematic analysis method to identify themes.RESULTS: Before treatment, patients thought they were not, or minimally, informed about (expected) treatment outcomes, but they felt well informed about treatment procedures and possible complications. Although patients expected pain relief and improvement in daily functioning, they found it difficult to describe any recovery timeline or the impact of these expected improvements on their daily life. Patients generally understood that treatment was not curative, but lacked insight into the impact of treatment on life expectancy given that this was hardly discussed by their surgeon and/or radiation oncologist. Pretreatment expectations regarding pain and daily functioning were only partially met in most patients post-treatment.CONCLUSIONS: Patients thought they were not, or only minimally, informed about expected outcomes after surgery and/or radiation therapy for symptomatic spinal metastases. Improvements in patient-physician communication and counseling could help guide patients toward realistic pretreatment expectations.
AB - OBJECTIVES: Patients with spinal metastases often receive palliative surgery or radiation therapy to maintain or improve health-related quality of life. Patients with unrealistic expectations regarding treatment outcomes have been shown to be less satisfied with their post-treatment health status. This study evaluated expectations of patients with spinal metastases scheduled for surgery and/or radiation therapy.METHODS: Individual semistructured interviews were conducted with patients with symptomatic spinal metastases before and 6 weeks after surgery and/or radiation therapy. Expectations regarding treatment outcomes were discussed before treatment, and level of fulfillment of these pretreatment expectations was discussed after treatment. Interviews were recorded, transcribed and analyzed according to the thematic analysis method to identify themes.RESULTS: Before treatment, patients thought they were not, or minimally, informed about (expected) treatment outcomes, but they felt well informed about treatment procedures and possible complications. Although patients expected pain relief and improvement in daily functioning, they found it difficult to describe any recovery timeline or the impact of these expected improvements on their daily life. Patients generally understood that treatment was not curative, but lacked insight into the impact of treatment on life expectancy given that this was hardly discussed by their surgeon and/or radiation oncologist. Pretreatment expectations regarding pain and daily functioning were only partially met in most patients post-treatment.CONCLUSIONS: Patients thought they were not, or only minimally, informed about expected outcomes after surgery and/or radiation therapy for symptomatic spinal metastases. Improvements in patient-physician communication and counseling could help guide patients toward realistic pretreatment expectations.
KW - palliative treatment
KW - patient expectations
KW - spinal metastases
KW - treatment outcomes
UR - https://www.scopus.com/pages/publications/85131447758
U2 - 10.1016/j.jval.2022.05.001
DO - 10.1016/j.jval.2022.05.001
M3 - Article
C2 - 35672228
SN - 1098-3015
VL - 26
SP - 4
EP - 9
JO - Value in Health
JF - Value in Health
IS - 1
ER -