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Identity construction and meaning-making after subarachnoid haemorrhage
Jönköping University, School of Health Science, HHJ. Quality improvements, innovations and leadership in health care and social work. Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
Jönköping University, School of Health Science, HHJ, Dep. of Nursing Science.
School of Life Sciences, University of Skövde, Sweden.
2010 (English)In: British journal of neuroscience nursing, Vol. 6, no 2, 86-93 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim was to analyse people’s accounts of subarachnoid haemorrhage (SAH) and to describe how they initiate and create meaning for the onset and events surrounding the SAH.

Background: Being struck by a SAH is a dramatic event, often followed byunconsciousness. There is therefore a special need for a patient to try tocreate some kind of meaning for the event during recovery andafterwards.

Method: Nine interviews were carried out in home settings and discourse analysis was used to interpret the data.

Findings: People stricken by SAH seem to be able to judge from memory for when they were becoming ill. Critical events related to SAH were existential threats and existential insights; and time as ‘waiting’ and timeas ‘structuring meaning’. The reconstruction of the illness event may be interpreted as an identity-creating process.

Conclusions: The reconstruction of the illness is a tool that can be used by nurses and other health professionals to understand a patient’s self positioning and identity-construction.

Place, publisher, year, edition, pages
2010. Vol. 6, no 2, 86-93 p.
Keyword [en]
Subarachnoid haemorrhage, Illness narratives, Pain, Memory, Meaning-making, Identity construction
National Category
Nursing
Identifiers
URN: urn:nbn:se:hj:diva-14447OAI: oai:DiVA.org:hj-14447DiVA: diva2:392431
Available from: 2011-01-27 Created: 2011-01-27 Last updated: 2012-11-16Bibliographically 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. 86 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 39
Keyword
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: 2012-11-26Bibliographically approved

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