Factors affecting surgery decision-making in patients with a chronic neurovascular condition.

AIMS AND OBJECTIVES: To explore the factors that affect patient decision-making for an elective surgery. BACKGROUND: Cerebral cavernous malformations are lesions found in the brain and spinal cord comprised of abnormal blood vessels, which bleed sporadically causing serious neurological deficits. Course of treatment for cerebral cavernous malformation is often ultimately left up to the patient, and can include symptom management or surgery. Decision-making for surgery in life-threatening conditions has been well documented in the literature. Less extensive research has focused on elective surgeries, where patients have a choice. There has been no research on the factors that affect decision-making for cavernous malformation patients. DESIGN: Correlational self-report survey. METHODS: In part of a larger online study, participants were asked to rate the importance of six factors on their decision-making about surgery for cavernous malformation. RESULTS: Factors that were rated most important for individuals' decision-making included doctor's opinion regarding surgery, presence of disabling symptoms, fear of symptoms getting worse or developing new symptoms, and availability of an expert surgeon. Results indicated that these were rated as more important than having social support during recovery or having the means to pay for surgery. Additionally, having social support during recovery was rated as significantly more important than having the means to pay for surgery. CONCLUSIONS: Factors that affect decision-making for patients diagnosed with cavernous malformation were similar to those found with other medical conditions requiring elective surgery. This study will assist healthcare workers in understanding the decision-making process of individuals who may choose an elective surgery for potentially disabling conditions with uncertain outcomes. RELEVANCE TO CLINICAL PRACTICE: Understanding the complex factors that affect decision-making in cavernous malformation will assist healthcare professionals to better communicate and support patients in their elective surgery decision-making.