An interpretative phenomenological analysis of the patient experience of awake craniotomy: brain tumour diagnosis to discharge

Objectives. Previous research exploring the patient experience of awake craniotomy (AC) has yielded contrasting accounts. The current study aimed to explore the lived experience of having undergone an AC in the United Kingdom. Design. This was a qualitative, semi-structured interview study. Interviews were audio-recorded and transcribed verbatim. Data were analysed using interpretative phenomenological analysis (IPA). Methods. Seven participants (three males, four females) who had undergone an AC in the United Kingdom took part in the study. Ages ranged between 26 and 41 years old at the time of interview. Time since AC ranged from 5 months to 4 years. Results. Participants appeared to be satisfied with, and tolerant of, the AC experience. Three superordinate themes: use of self-preservation strategies prior to and during AC, a bizarre yet pleasant operation experience, and the need for more concrete information prior to surgery were identified. These themes appeared to be embedded in a core theme: relationship with the neurosurgeon. Conclusions. The relationship with the neurosurgeon appears crucial to the patient experience of AC. This knowledge underscores the need for effective doctor–patient communication skills which could lead to improved delivery of care and more positive outcomes

CLINICAL REHABILITATION

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CLINICAL REHABILITATION Communication and Low Mood (CALM): a randomized controlled trial of behavioural therapy for stroke patients with aphasia Article

Abstract Objective: The aim was to evaluate behavioural therapy as a treatment for low mood in people with aphasia. Design: A randomized controlled trial comparing behavioural therapy plus usual care with a usual care control. Potential participants with aphasia after stroke were screened for the presence of low mood. Those who met the criteria and gave consent were randomly allocated. Setting: Participants were recruited from hospital wards, community rehabilitation, speech and language therapy services and stroke groups. Subjects: Of 511 people with aphasia identified, 105 had low mood and were recruited. Interventions: Behavioural therapy was offered for up to three months. Outcomes were assessed three and six months after random allocation. Main measures: Stroke Aphasic Depression Questionnaire, Visual Analog Mood Scales 'sad' item, and Visual Analogue Self-Esteem Scale. Results: Participants were aged 29 to 94 years (mean 67.0, SD 13.5) and 66 (63%) were men. Regression analysis showed that at three months, when baseline values and communication impairment were controlled for, group allocation was a significant predictor of the Stroke Aphasic Depression Questionnaire (P < 0.05), visual analogue 'sad' (P = 0.03), and Visual Analogue Self-Esteem Scale (P < 0.01). At six months, group alone was a significant predictor of the Stroke Aphasic Depression Questionnaire (P < 0.05), and remained significant when baseline values were controlled for (P = 0.02). Mean Stroke Aphasic Depression Questionnaire 10-item hospital version scores decreased from baseline to six months by six points in the intervention group as compared with an increase of 1.9 points in the control group. Conclusions: Behavioural therapy seemed to improve the mood of people with aphasia

Psychological Management of Stroke

Psychological Management of Stroke presents a review and synthesis of the current theory and data relating to the assessment, treatment, and psychological aspects of stroke. Provides comprehensive reviews of evidence based practice relating to stroke Written by clinical psychologists working in stroke services Covers a broad range of psychological aspects, including fitness to drive, decision making, prevention of stroke, and involvement of carers and families Reviews and synthesizes new data across a wide range of areas relevant to stroke and the assessment, treatment, and care of stroke survivors and their families Represents a novel approach to the application of psychological theory and principles in the stroke field