J Neurol Surg B Skull Base 2015; 76(02): 129-144
DOI: 10.1055/s-0034-1371520
Original Article
Georg Thieme Verlag KG Stuttgart · New York

Changes Experienced in Quality of Life for Skull Base Surgical Patients: A Qualitative Case Study

John R. de Almeida
1   Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, Canada
2   Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
,
Allan D. Vescan
1   Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, Canada
,
Ian J. Witterick
1   Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, Canada
,
Patrick J. Gullane
1   Department of Otolaryngology—Head and Neck Surgery, University of Toronto, Toronto, Canada
,
Fred Gentili
3   Division of Neurosurgery, University of Toronto, Toronto, Canada
,
Jolie Ringash
4   Department of Radiation Oncology, University of Toronto, Toronto, Canada
,
Achilles Thoma
2   Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
,
Lynne Lohfeld
2   Department of Clinical Epidemiology and Biostatistics, McMaster University, Hamilton, Canada
› Author Affiliations
Further Information

Publication History

01 August 2012

28 December 2013

Publication Date:
06 November 2014 (online)

Preview

Abstract

Objective Skull base tumors are associated with quality of life (QOL) changes. A qualitative case-study approach may help better understand patients' experiences.

Methods A total of 34 skull base surgery patients were selected into focus groups using a criterion-based maximum variation sampling strategy from a sampling frame of 138 patients. Eight groups were organized based on a factorial design of surgical approach (endoscopic/pen) and tumor location (anterior/central). Data were analyzed using a conceptual framework. Qualitative analysis was performed on focus group transcripts to identify major themes and determine if surgical approach or tumor location had differential effects on QOL. Concepts were quantitatively tallied from written workbooks.

Results The 34 participants (19 men, 15 women; mean age: 48 years, standard deviation: 14 years) had mixed reactions to their diagnosis ranging from relief to fear. Participants reported physical and nonphysical changes in QOL with some variation in physical complaints by tumor location. Several major themes emerged from the analysis. Skull base tumors are associated with fear and frustration, loss of physical senses and self-identity, social isolation, and coping mechanisms.

Conclusions Skull base surgery may impact patients' lives. Qualitative study of patient experiences can provide rich information to better understand this disease.

Supplementary Material