Validating the Neuro-oncology Grief Index (NOGI) for Neurosurgical Oncologists: An AANS/CNS Joint Tumor Section Study

Introduction: Many neurosurgical-oncologists frequently grapple with the loss of patients. However, there have been no formal attempts to study how they cope with these emotionally-charged situations. This study aims to explore their coping strategies through the Neuro-Oncology Grief Index (NOGI).

Methods: For this study, members of the American Association of Neurological Surgeons/Congress of Neurological Surgeons (AANS/CNS) Joint Tumor Section were invited to participate in a survey. They were asked to complete a demographic section followed by a series of questions regarding the respondents’ exposure to end of life care. The final section invited respondents to complete items from the NOGI questionnaire.

Results: Our respondents included 26 practicing neurosurgeons, of whom 17(65%) practiced in academic hospitals. Nineteen(73%) had no systems in place for after care and 15(58%) relied on peers for support while 18(69%) relied on family and friends. Most respondent were married or partnered (24,92%) and 20(77%) had children. Ten(38%) reported sometimes blaming themselves for a patient’s death, while 9(35%) reported this usually or always. Ten(38%) reported always or usually still finding it difficult to accept the death of a patient. Nineteen(73%) mentioned usually or always trying to remain busy after the death of a patient while six(23%) reported this sometimes. Six(24%) sometimes tried to be strong for others while 19(76%) said this was true usually or always. Eighteen(69%) reported usually or always grieving alone. Twenty-six(100%) reported they never engaged with risky sexual behaviors, used prescription drugs, or used nicotine products to cope.

Conclusion : Despite having to cope with the death of patients, neurosurgical-oncologists have few opportunities for training or structured support to handle these situations. Many blame themselves for their patients’ deaths and try to cope with the emotions by themselves. The field could benefit from the development of further coping mechanisms and the implementation of regular check-ins using the NOGI.