Epilepsy Surgery : Factors That Affect Patient Decision-Making in Choosing or Deferring a Procedure
Surgical resection for well-selected patients with refractory epilepsy provides seizure freedom approximately two-thirds of the time. Despite this, many good candidates for surgery, after a presurgical workup, ultimately do not consent to a procedure. The reasons why patients decline potentially eff...
Saved in:
Published in | Epilepsy research and treatment Vol. 2013; no. 2013; pp. 1 - 13 |
---|---|
Main Authors | , , , , |
Format | Journal Article |
Language | English |
Published |
Cairo, Egypt
Hindawi Puplishing Corporation
01.01.2013
Hindawi Publishing Corporation Hindawi Limited |
Subjects | |
Online Access | Get full text |
Cover
Loading…
Summary: | Surgical resection for well-selected patients with refractory epilepsy provides seizure freedom approximately two-thirds of the time. Despite this, many good candidates for surgery, after a presurgical workup, ultimately do not consent to a procedure. The reasons why patients decline potentially effective surgery are not completely understood. We explored the socio cultural, medical, personal, and psychological differences between candidates who chose (n = 23) and those who declined surgical intervention (n = 9). We created a novel questionnaire addressing a range of possible factors important in patient decision making. We found that patients who declined surgery were less bothered by their epilepsy (despite comparable severity), more anxious about surgery, and less likely to listen to their doctors (and others) and had more comorbid psychiatric disease. Patients who chose surgery were more embarrassed by their seizures, more interested in being “seizure-free”, and less anxious about specific aspects of surgery. Patient attitudes, beliefs, and anxiety serve as barriers to ideal care. These results can provide opportunities for education, treatment, and intervention. Additionally, patients who fit a profile of someone who is likely to defer surgery may not be appropriate for risky and expensive presurgical testing. |
---|---|
Bibliography: | ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 23 Academic Editor: Giangennaro Coppola |
ISSN: | 2090-1348 2090-1356 |
DOI: | 10.1155/2013/309284 |