Patient-centered consultation in neuro-oncology: A qualitative meta-synthesis of brain tumor patients' experiences with treatment decision-making.

Abstract

This meta-synthesis integrates qualitative evidence on how brain tumor patients' experiences of treatment decision-making consultations in order to identify the essential elements of a patient-centered consultation framework tailored to their needs. We used a Thomas and Harden's approach. Systematic search was conducted in Web of Science, PubMed, Embase, and Scopus for studies until June 15th, 2025. All included studies were critically appraised using the Joanna Briggs Institute (JBI) Critical Appraisal Checklist for Qualitative Research. The study was registered on PROSPERO with registration number CRD42023457607. This synthesis identified four analytical themes that should guide healthcare providers: (1) consultations must address emotional and existential concerns; (2) communication should be personalized; (3) decision-making must remain flexible, allowing patients to delegate control to trusted others when desired; and (4) the irreplaceable and multifaceted roles of family and social support. Our findings reveal a persistent gap in shared decision-making among brain tumor patients, many of whom defer decisions to physicians due to emotional distress, cognitive limitations, and informational barriers. Enhancing patient-centered care therefore requires strategies that strengthen trust, support patient engagement, and address these structural and emotional challenges. Clinical consultation should consider about patients' emotional and existential concerns, incorporate personalized communication, adopt a flexible approach to decision-making, and appropriately involve family and social support.