Psychosocial outcomes for patients and carers after aneurysmal subarachnoid haemorrhage

Abstract

As part of a 'clinical governance' initiative, a patient/carer led study was designed to determine the psychosocial outcome of a consecutive cohort of 137 aneurysmal sub-arachnoid haemorrhage (ASAH) patients of whom 45% had experienced a severe haemorrhage. Most patients were middle class (51%), female (63%), aged under 54 years (53%) and 30% had school-age children. Information booklets did not meet the need for case-specific answers and communication problems were identified despite the high rating of in-patient treatment. Substantial problems occurred after discharge because of a hiatus in care and support by community-based services. Carers carried major psychosocial burdens, fifty-one per cent reporting that their work was negatively affected, and after a year, employment cost to carers was pounds sterling 182,000 and pounds sterling 590,000 for patients. 11% of patients lost their jobs as a direct consequence of the ASAH. A cost-feasible solution to improve the communication-support problems was identified by these 'consumers'.

The impact of care on carers of patients treated for aneurysmal subarachnoid haemorrhage

“…The high response rate of 68.6% over this length of follow up may also be indicative of the level of unresolved psychosocial problems. The fact that the majority of carers were family members is in accord with the study by Pritchard et al 2 Most survivors of ASAH make a satisfactory neurological recovery, but on careful assessment a significant number are found to have cognitive, physical, psychosocial and emotional difficulties. 9,16 Depression is often unrecognized.…”

“…Although very few papers have addressed quality of life in patients following ASAH it has, nevertheless, been established that psychosocial problems persist in patients with good clinical recoveries. 9,10 There are even fewer studies that have addressed the burden on caregivers, 1,2,11,12 but it is becoming apparent that carers of these patients often suffer psychosocial stress. It is generally assumed that care related stress reduces with time.…”

Gene Expression Profiles in Human Ruptured and Unruptured Intracranial Aneurysms

“…1 Approximately 85% of nontraumatic subarachnoid hemorrhage cases are caused by rupture of an intracranial aneurysm (IA). The overall incidence of IA is 4% to 6%, with asymptomatic IA at least 10-times more prevalent than ruptured IA (RA).…”

The patient's voice in neuro‐surgery: psycho‐socio‐economic benefits of a patient‐designed versus standard service following treatment for a subarachnoid haemorrhage

“…The originality of this TAU study was that not only did it include patients and carer's psychosocial PROM outcomes, but also what had previously been missed, the extent of fiscal and economic costs to both service and especially to the families of unsupported SAH patients (Pritchard et al, 2001). This highlights the importance of trying to maximise the patient's potential capacity to re-establish their lives, within the reality of the degree of any permanent brain damage.…”