Perception of neurosurgery among surgical patients with essential tremor: A qualitative mixed methods study

Background: There is a dearth of evidence on knowledge and perceptions of procedures among patients with essential tremor (ET). The objective of this study was to utilize a mixed methods design incorporating in-depth individual interviews to investigate the perception of procedures among patients wi...

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Main Authors: Susanna D. Howard, Ellie Gabriel, Shikha Singh, Iahn Cajigas, Whitley Aamodt, John Farrar, Matthew D. Kearney
Format: Article
Language:English
Published: Elsevier 2025-10-01
Series:World Neurosurgery: X
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Online Access:http://www.sciencedirect.com/science/article/pii/S259013972500078X
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author Susanna D. Howard
Ellie Gabriel
Shikha Singh
Iahn Cajigas
Whitley Aamodt
John Farrar
Matthew D. Kearney
author_facet Susanna D. Howard
Ellie Gabriel
Shikha Singh
Iahn Cajigas
Whitley Aamodt
John Farrar
Matthew D. Kearney
author_sort Susanna D. Howard
collection DOAJ
description Background: There is a dearth of evidence on knowledge and perceptions of procedures among patients with essential tremor (ET). The objective of this study was to utilize a mixed methods design incorporating in-depth individual interviews to investigate the perception of procedures among patients with ET who underwent surgical intervention. Methods: Semi-structured, in-depth individual interviews paired with survey questionnaires were conducted among participants with ET who had a prior surgical procedure for the disorder. Thematic analysis of qualitative data was conducted using an approach based on grounded theory methodology. Results: Of the 20 patients interviewed, nine patients (45 %) had undergone magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy, nine patients (45 %) had undergone deep brain stimulation (DBS) implantation, and two patients (10 %) had undergone both DBS implantation and MRgFUS thalamotomy. In ranking factors from most to least important in deciding which type of surgery to undergo, patients most frequently selected safety as the most important factor (9/20, 45 %). Hair shave required was most frequently selected as the least important factor (14/20, 70 %). Seven patients (35 %) reported having zero or minimal knowledge of the risks and benefits of either MRgFUS thalamotomy or DBS before their surgery. Patients discussed their surgical outcomes including adverse effects of surgery. Conclusions: In deciding which type of surgery to undergo for tremor, participants discussed the role of safety, perceived invasiveness, and follow-up care required. Participants reflected on the life-changing benefits of tremor control but also discussed detrimental adverse effects such as dysarthria and gait instability following surgery.
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spelling doaj-art-69ecfbb514224dabb87cf2b3f66091392025-08-20T03:38:19ZengElsevierWorld Neurosurgery: X2590-13972025-10-012810050410.1016/j.wnsx.2025.100504Perception of neurosurgery among surgical patients with essential tremor: A qualitative mixed methods studySusanna D. Howard0Ellie Gabriel1Shikha Singh2Iahn Cajigas3Whitley Aamodt4John Farrar5Matthew D. Kearney6Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA; Corresponding author. Department of Neurosurgery, University of Pennsylvania Perelman Center for Advanced Medicine 15 South Tower, 3400 Civic Center Blvd, Philadelphia, PA, 19104, USA.University of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USAUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USADepartment of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USADepartment of Neurology, University of Pennsylvania, Philadelphia, PA, USADepartment of Biostatistics and Epidemiology, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USAUniversity of Pennsylvania Perelman School of Medicine, Philadelphia, PA, USA; Department of Family Medicine and Community Health, University of Pennsylvania, Philadelphia, PA, USABackground: There is a dearth of evidence on knowledge and perceptions of procedures among patients with essential tremor (ET). The objective of this study was to utilize a mixed methods design incorporating in-depth individual interviews to investigate the perception of procedures among patients with ET who underwent surgical intervention. Methods: Semi-structured, in-depth individual interviews paired with survey questionnaires were conducted among participants with ET who had a prior surgical procedure for the disorder. Thematic analysis of qualitative data was conducted using an approach based on grounded theory methodology. Results: Of the 20 patients interviewed, nine patients (45 %) had undergone magnetic resonance-guided focused ultrasound (MRgFUS) thalamotomy, nine patients (45 %) had undergone deep brain stimulation (DBS) implantation, and two patients (10 %) had undergone both DBS implantation and MRgFUS thalamotomy. In ranking factors from most to least important in deciding which type of surgery to undergo, patients most frequently selected safety as the most important factor (9/20, 45 %). Hair shave required was most frequently selected as the least important factor (14/20, 70 %). Seven patients (35 %) reported having zero or minimal knowledge of the risks and benefits of either MRgFUS thalamotomy or DBS before their surgery. Patients discussed their surgical outcomes including adverse effects of surgery. Conclusions: In deciding which type of surgery to undergo for tremor, participants discussed the role of safety, perceived invasiveness, and follow-up care required. Participants reflected on the life-changing benefits of tremor control but also discussed detrimental adverse effects such as dysarthria and gait instability following surgery.http://www.sciencedirect.com/science/article/pii/S259013972500078XEssential tremorNeurosurgeryQualitative research
spellingShingle Susanna D. Howard
Ellie Gabriel
Shikha Singh
Iahn Cajigas
Whitley Aamodt
John Farrar
Matthew D. Kearney
Perception of neurosurgery among surgical patients with essential tremor: A qualitative mixed methods study
World Neurosurgery: X
Essential tremor
Neurosurgery
Qualitative research
title Perception of neurosurgery among surgical patients with essential tremor: A qualitative mixed methods study
title_full Perception of neurosurgery among surgical patients with essential tremor: A qualitative mixed methods study
title_fullStr Perception of neurosurgery among surgical patients with essential tremor: A qualitative mixed methods study
title_full_unstemmed Perception of neurosurgery among surgical patients with essential tremor: A qualitative mixed methods study
title_short Perception of neurosurgery among surgical patients with essential tremor: A qualitative mixed methods study
title_sort perception of neurosurgery among surgical patients with essential tremor a qualitative mixed methods study
topic Essential tremor
Neurosurgery
Qualitative research
url http://www.sciencedirect.com/science/article/pii/S259013972500078X
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