TY - JOUR
T1 - Pre-treatment expectations of patients with spinal metastases
T2 - what do we know and what can we learn from other disciplines? A systematic review of qualitative studies
AU - Gal, R
AU - Oostinga, D
AU - Wessels, H
AU - Verlaan, J J
AU - Charest-Morin, R
AU - Fisher, C G
AU - Verkooijen, H M
AU - Versteeg, A L
N1 - Funding Information:
This study was funded by AOSpine International. The funder had no role in study design, data collection and analysis, interpretation of data, and preparation of the manuscript.
Publisher Copyright:
© 2020, The Author(s).
Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.
Funding Information:
This study was funded by AOSpine International. The funder had no role in study design, data collection and analysis, interpretation of data, and preparation of the manuscript.
Publisher Copyright:
© 2020, The Author(s).
PY - 2020/12/9
Y1 - 2020/12/9
N2 - BACKGROUND: Little is known about treatment expectations of patients with spinal metastases undergoing radiotherapy and/or surgery. Assuming that patients with spinal metastases share characteristics with patients who had spinal surgery for non-cancer related conditions and with advanced cancer patients, we performed a systematic review to summarize the literature on patient expectations regarding treatment outcomes of spinal surgery and advanced cancer care.METHODS: A comprehensive search was performed in MEDLINE, EMBASE and PsycINFO for studies between 2000 and sep-2019. Studies including adult patients (> 18 years), undergoing spinal surgery or receiving advanced cancer care, investigating patients' pre-treatment expectations regarding treatment outcomes were included. Two independent reviewers screened titles, abstracts and full-texts, extracted data and assessed methodological quality.RESULTS: The search identified 7343 articles, of which 92 were selected for full-text review. For this review, 31 articles were included. Patients undergoing spinal surgery had overly optimistic expectations regarding pain and symptom relief, they underestimated the probability of functional disability, and overestimated the probability of (complete) recovery and return to work. Studies highlighted that patients feel not adequately prepared for surgery in terms of post-treatment expectations. Similarly, advanced cancer patients receiving palliative treatment often had overly optimistic expectations regarding their survival probability and cure rates.CONCLUSIONS: Patients tend to have overly optimistic expectations regarding pain and symptom relief, recovery and prognosis following spinal surgery or advanced cancer care. Pretreatment consultation about the expected pain and symptom relief, recovery and prognosis may improve understanding of prognosis, and promote and manage expectations, which, in turn, may lead to better perceived outcomes.TRIAL REGISTRATION: PROSPERO registration number: CRD42020145151 .
AB - BACKGROUND: Little is known about treatment expectations of patients with spinal metastases undergoing radiotherapy and/or surgery. Assuming that patients with spinal metastases share characteristics with patients who had spinal surgery for non-cancer related conditions and with advanced cancer patients, we performed a systematic review to summarize the literature on patient expectations regarding treatment outcomes of spinal surgery and advanced cancer care.METHODS: A comprehensive search was performed in MEDLINE, EMBASE and PsycINFO for studies between 2000 and sep-2019. Studies including adult patients (> 18 years), undergoing spinal surgery or receiving advanced cancer care, investigating patients' pre-treatment expectations regarding treatment outcomes were included. Two independent reviewers screened titles, abstracts and full-texts, extracted data and assessed methodological quality.RESULTS: The search identified 7343 articles, of which 92 were selected for full-text review. For this review, 31 articles were included. Patients undergoing spinal surgery had overly optimistic expectations regarding pain and symptom relief, they underestimated the probability of functional disability, and overestimated the probability of (complete) recovery and return to work. Studies highlighted that patients feel not adequately prepared for surgery in terms of post-treatment expectations. Similarly, advanced cancer patients receiving palliative treatment often had overly optimistic expectations regarding their survival probability and cure rates.CONCLUSIONS: Patients tend to have overly optimistic expectations regarding pain and symptom relief, recovery and prognosis following spinal surgery or advanced cancer care. Pretreatment consultation about the expected pain and symptom relief, recovery and prognosis may improve understanding of prognosis, and promote and manage expectations, which, in turn, may lead to better perceived outcomes.TRIAL REGISTRATION: PROSPERO registration number: CRD42020145151 .
KW - Advanced cancer
KW - Patient expectations
KW - Spinal metastases
KW - Spine surgery
KW - Treatment outcomes
UR - http://www.scopus.com/inward/record.url?scp=85097386495&partnerID=8YFLogxK
U2 - 10.1186/s12885-020-07683-7
DO - 10.1186/s12885-020-07683-7
M3 - Article
C2 - 33298017
SN - 1471-2407
VL - 20
JO - BMC Cancer
JF - BMC Cancer
IS - 1
M1 - 1212
ER -