Oral Presentation Clinical Oncology Society of Australia Annual Scientific Meeting 2024

‘What is this brain’s story?’: Healthcare professionals' management of brain tumour related personality and behaviour changes (#88)

Emma McDougall 1 , Anna Nowak 2 , Haryana Dhillon 3 , Lauren Breen 4 5 , Karin Piil 6 , Georgia KB Halkett 1
  1. Curtin School of Nursing/Curtin Health Innovation Research Institute, Curtin University, Perth, WA, Australia
  2. Medical School, University of Western Australia, Perth, WA, Australia
  3. Psycho-Oncology Cooperative Research Group, The University of Sydney, Sydney, NSW, Australia
  4. Curtin enAble Institute, Curtin University, Perth, WA, Australia
  5. Curtin School of Population Health, Curtin University, Perth, WA, Australia
  6. Department of Oncology, Copenhagen University Hospital, Copenhagen, Denmark

Background: Management of brain tumour related personality and behaviour changes (BTrPBc) is complex. Contributing factors include tumour location, treatment side effects, and psychological adjustment to the diagnosis. Whilst clinicians’ roles should include providing support and management for personality and behaviour changes, scant research has focused on management of BTrPBc.

Aim: We aimed to explore how neuro-oncology healthcare professionals manage personality and behaviour changes in adults with a primary brain tumour

Method: An interpretive description approach was taken, with semi-structured interviews conducted with healthcare professionals practicing in neuro-oncology across Australia. Interview recordings were transcribed and analysed using thematic analysis.

Results: Twenty-two interdisciplinary healthcare professionals practicing in neuro-oncology participated in interviews with a median duration of 34 minutes (range 17 - 57 minutes). Four key themes were developed. The first, "Building trusting relationships," included sub-themes 'Involving and supporting carers,' and 'Respecting patients' autonomy and confidentiality.' The second theme, "What is this brain's story?", incorporated the sub-theme 'Sharing care.' The third theme, “Brief Intervention”, encompassed the sub-themes 'Information provision' and ‘That's the tumour talking.’ Lastly, “Targeted Intervention,” includes the sub-themes 'Modifying environments and managing cognitive resources,' 'Acceptance of personality changes,' and ‘Enriching the relationship’.

Healthcare professionals recognised the need to build trusting relationships with patients and carers to be able to discuss sensitive or difficult experiences including personality changes. Healthcare professionals emphasised involving carers in patient care and ensuring carers have their own support. Finally, participants highlighted the importance of providing information about causes and contributing factors to BTrPBc and possible impacts on functioning.

Conclusion: Our results provide insight into the diverse support healthcare professionals provide for the management of BTrPBc. Our data point to the potential for a stepped care approach to managing BTrPBc, however further testing in clinical practice is required.