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Subarachnoid haemorrhage has long-term effects on social life
Jönköping University, School of Health and Welfare, HHJ. Quality improvements, innovations and leadership in health care and social work.
Högskolan i Skövde, Forskningscentrum för Systembiologi.ORCID iD: 0000-0002-4724-0269
2011 (English)In: British Journal of Neuroscience Nursing, ISSN 1747-0307, E-ISSN 2052-2800, Vol. 7, no 1, p. 429-435Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to describe activities of living after a subarachnoid haemorrhage (SAH) from the perspective of relatives and patients in two cohorts and to evaluate the application of relatives’ statements, as a tool in nursing care, in order to support the patient.

Background: Memory problems after SAH are common according to patients’ and relatives’ statements and memory test results. This may influence the adjustment to daily life. Supporting patients and relatives requires knowledge concerning the activities of daily living from the perspective of both patients and relatives.

Method:Eleven relatives and 11 patients (cohort 1), 11 years after the onset of an SAH and 15 relatives and 15 patients (cohort 2) 6 years after the onset of an SAH participated in the study. Interview questions and memory tests were used to collect data.

Findings:Problems with activities of daily living were common and patients had more problems with social life than with personal and instrumental activites. The change in social company habits were due to emotional problems. Patients’ statements about problems with activities of living corresponded to results from patients’ memory tests and patients’ statements.

Conclusions: Relatives’ and patients’ statements are useful as tools in nursing care. Introducing fromalized dialogues and memory tests would improve the after care for this group of patients and improve their future family relationships.

Place, publisher, year, edition, pages
MA Healthcare , 2011. Vol. 7, no 1, p. 429-435
Keywords [en]
subarachnoid haemorrhage, memory tests, daily life, interview questions, activities of living
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-19837OAI: oai:DiVA.org:hj-19837DiVA, id: diva2:570177
Available from: 2012-11-16 Created: 2012-11-16 Last updated: 2017-11-28Bibliographically approved
In thesis
1. Daily life after Subarachnoid Haemorrhage: Identity construction, patients’ and relatives’ statements about patients’ memory, emotional status and activities of living
Open this publication in new window or tab >>Daily life after Subarachnoid Haemorrhage: Identity construction, patients’ and relatives’ statements about patients’ memory, emotional status and activities of living
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe patients’ experience and reconstruction regarding the onset of, and events surrounding being struck by a Subarachnoid Haemorrhage (SAH), and to describe patients’ and relatives’ views of patients’ memory ability, emotional status and activities of living, in a long-term perspective.

Methods: Both inductive and deductive approaches were used. Nine open interviews were carried out in home settings, in average 1 year and 7 seven months after the patients’ onset, and discourse analysis was used to interpret the data. Eleven relatives and 11 patients, 11 years after the onset, and 15 relatives and 15 patients, 6 years after the onset, participated in two studies. Interviews using a questionnaire with structured questions and memory tests were used to collect data. Fischer’s exact test and Z-scores were used for the statistical analysis.

Results: Patients with experience of a SAH were able to judge their own memory for what happened when they became ill. The reconstruction of the illness event may be interpreted as an identity creating process. The process of meaning-making is both a matter of understanding SAH as a pathological event and a social and communicative matter, where the SAH is construed into a meaningful life history, in order to make life complete (I). Memory problems, changes in emotional status and problems with activities of living were common (II-IV). There was correspondence between relatives’ and patients’ statements regarding the patients’ memory in general and long-term memory. Patients judged their own memory ability better than relatives, compared with results on memory tests. Relatives stated that some patients had meta-memory problems (II). The episodic memory seemed to be well  reserved, both concerning the onset and in the long-term perspective (I, II). There were more problems with social life than with P- and I-ADL (III), and social company habits had changed due to concentration difficulties, mental fatigue, and  patients’ sensitivity to noisy environments and uncertainty (IV). Relatives rated the patients’ ability concerning activities of living and emotional status, and in a similar manner to patients’ statements (III-IV).

Conclusions: The reconstruction of the illness event can be used as a tool in nursing for understanding the patient’s identity-construction. Relatives and patients stated the patients’ memory, emotional status and activities of living in a similar manner, and therefore both patients’ and relatives’ statements can be used as a tool in nursing care, in order to support the patient. However, the results showed: meta-memory problems (relatives’ statements) and that the patients’ judged their own memory ability better than relatives in comparison with results on memory tests. Nevertheless, there was a high degree of concordance between relatives’ and patients’ evaluations concerning patients´ memory ability, emotional status, emotional problems, social company habits and activities of living. Therefore both relatives’ and patients’ statements can be considered to be reliable. However, sometimes the patients and the relatives judge the patients’ memory differently. Consequently, memory tests and formalized dialogues between the patient, the relative and a professional might be required, in order to improve the mutual family relationship in a positive way. Professionals however, must first assume that patients can judge their own memory, emotional status and ability in daily life.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences, 2012. p. 86
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 39
Keywords
SAH, Stroke, Pain, Memory, Decisions, Meaning-making, Identity-construction, Psychological sequelae, Emotional status, Social life, P-and I-ADL, Memory tests, Interviews, Questionnaire
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-19840 (URN)978-91-85835-38-6 (ISBN)
Supervisors
Available from: 2012-11-16 Created: 2012-11-16 Last updated: 2018-09-10Bibliographically approved

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