Exploring patient-neurosurgical team inter-relationships throughout the perioperative period of awake craniotomy

The portfolio thesis is divided into three parts: a systematic literature review, an empirical study, and appendices.Part one is a systematic literature review exploring definitions, measures and influencers of health-related quality of life (HRQofL) in brain tumour (BT) populations. The review was undertaken as no BT-specific HRQofL definition currently exists, literature remains unclear regarding the existence of reliable and valid BT-specific measures, and little is known about factors associated with HRQofL that may be amenable to change. A systematic search of four databases identified 13 relevant studies. No accepted HRQofL definition emerged. Only two validated BT-specific HRQofL measures were reported and numerous variables influencing HRQofL were identified within themes of ‘patient’, ‘tumour’, and ‘social support’ factors. Findings provided recommendations for future research and useful insights for refining clinical practice.Part two is an empirical study exploring how both patients and neurosurgical team members experience awake craniotomy (AC) and make sense of their perioperative interactions. The qualitative study aimed to enhance knowledge surrounding efficacious approaches to build positive patient-practitioner relationships with the potential to improve overall AC experience. A patient and neurosurgical team group, each comprising eight participants, were interviewed and the data was analysed using Interpretative Phenomenological Analysis (IPA). Four superordinate and six subordinate themes, and three superordinate and seven subordinate themes emerged within patient and neurosurgical team groups respectively. Themes are discussed within the context of wider healthcare literature, identifying relevant clinical implications.Part three consists of appendices supporting the systematic literature review and the empirical study. It also includes a reflective statement of the ‘research experience’