Two-year prospective study of psychosocial outcomes and a cost-analysis of 'treatment-as-usual' versus an 'enhanced' (specialist liaison nurse) service for aneurysmal sub arachnoid haemorrhage (ASAH) patients and families

Pritchard, Colin; Foulkes, Lesley; Da, Lang; Neil‐Dwyer, G.

doi:10.1080/02688690400004993

Cited by 26 publications

(26 citation statements)

References 7 publications

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“…But with time, subtle cognitive, social, and emotional difficulties may place stress on the significant others and affect relationships. Liaison services, in terms of a neurovascular specialist nurse, with the role to support and counsel patients with aSAH and their families, have been tested in an intervention study (33) and resulted in improved family relationships. Pritchard et al (33) emphasize that liaison services can become a way to prevent psychosocial chronicity for patients with aSAH and their family carers.…”

Section: Discussionmentioning

confidence: 99%

Patients Experience High Levels of Anxiety 2 Years Following Aneurysmal Subarachnoid Hemorrhage

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Patients Experience High Levels of Anxiety 2 Years Following Aneurysmal Subarachnoid Hemorrhage

et al. 2015

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“…First aneurysms are now more often treated by endovascular surgery (coiling) rather than craniotomy (clipping). However, in the initial two Wessex regional studies, we found no statistically significant differences between the clipped and coiled patient's psychosocial outcomes (Pritchard et al, 2001(Pritchard et al, , 2004b.…”

Section: Limits To the Studymentioning

confidence: 66%

“…The additional psycho-socio-economic PROM data that was projected onto the matched national patients and their assumed carers included: All items from one to 14 can be found in the published papers on the TAU and SNVN cohorts (Pritchard et al, 2001(Pritchard et al, , 2004b.…”

Section: Matching Regional With National Patientsmentioning

confidence: 99%

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

Pritchard

Cox

Foulkes

et al. 2011

Social Care and Neurodisability

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Purpose -Successive governments have called for greater ''empowerment'' of the patient, reflected in the chief medical officer's call for more patient-related outcome measures (PROM). This paper aims to bring together three-linked studies.Design/methodology/approach -First study: in 1999, the neurosurgical patient was seen as ''expert'' to identify PROM outcomes, based upon a patient and carer-designed self-administered postal questionnaire in a regional two-year retrospective survey of subarachnoid haemorrhage (SAH) patients with a 77 per cent response rate, designated treatment-as-usual (TAU) cohort (n ¼ 142).Second study: in the same region, following the implementing of the specialist neuro-vascular nurse (SNVN), the SNVN recommendation was evaluated in a two-year prospective study (n ¼ 184) that provided family-specific psychosocial support and a continuity of care linking hospital and community; the response rate was 87 per cent. Third study: A re-analysis of the national SAH study (n ¼ 2,380), by projecting the TAU and SNVN results onto clinically matched patients within the National cohort to estimate the potential ''savings'' if all 34 neurosurgical units had an SNVN type service.Findings -First study: respondents identified many psychosocial and fiscal problems but recommended a SNVN to reduce these difficulties. Second study: the TAU and SNVN patient's were a close clinical match and using the TAU as a control group, it was found that there were major psychosocial and fiscal benefits for SNVN patients and carers, who more speedily re-established their lives.Third study: it was estimated that this would have produced major financial benefits, e.g. 4,165 fewer bed occupancy days, saving £2.5million; reduced time-off work for patients and carers, saving £8.1million; and, after deducting cost of a national SNVN service, a combined saving for the service and families of an estimated £9.83 million p.a. Thus, addressing PROM outcomes, through an integrated psychosocial service in neurosurgery was cost-effective, benefited families, the service, and the wider economy and should be a factor when considering pressurised departmental budgets.Originality/value -Overall, what the two regional studies and the re-analysis of the national study showed was that there are benefits from treating the ''patient as expert'' and taking on board their agendas. There is a need for a more integrated approach to treatment and care that is of value to the service, patients, families and the wider economy.

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“…Además, hay que tener en cuenta el trastorno de estrés postraumático causado por la propia percepción de enfermedad después de sufrir la hemorragia subaracnoidea que afecta también negativamente a la calidad de vida, según Berry (1998) 4 y Pritchard y cols. (2004) 27 . Lo que podemos concluir de todos estos estudios, es que la calidad de vida en estos pacientes no sólo depende de un factor, sino que interfieren muchos factores de diverso tipo, que todos afectan en diferente medida a la calidad de vida deteriorada de los pacientes que han sido tratados de un aneurisma intracraneal y que la modalidad de tratamiento solo explica una parte.…”

Section: Discussionunclassified

Calidad de vida en pacientes con aneurismas intracraneales: cirugía versus tratamiento endovascular

et al. 2006

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Recibido;325 Neurocirugía 2006; 17: Resumen Objetivo. Basados en estudios anteriores, nuestro propósito es determinar la calidad de vida de los pacientes con aneurismas intracraneales después de haber sido intervenido mediante cirugía o embolización y comparar la calidad de vida de estos dos grupos. Material y métodos. El cuestionario SF-36 fue aplicado retrospectivamente a 93 pacientes con aneurismas tratados mediante cirugía (n=56) o embolización (n=37).Resultados. La calidad de vida de los pacientes tratados con cirugía estaba deteriorada en el 50% y en los pacientes tratados por embolización el 40,5% no mostraron ningún deterioro en ninguno de los dominios del SF-36. Los análisis muestran que el dominio de la función física está menos deteriorada en los pacientes que han sido embolizados que los que han sido intervenidos quirúrgicamente.Conclusiones. Los pacientes con aneurismas intracraneales tratados mediante cirugía o embolización tienen afectada la calidad de vida. El tratamiento endovascular puede causar menos limitaciones en la función física. En la calidad de vida de estos pacientes influyen varios factores, además del tipo de tratamiento. PALABRAS CLAVE: Calidad de vida. Aneurismas intracraneales. Hemorragia subaracnoidea. Cirugía. Endovascular Quality of life in intracranial aneurysm: surgery versus endovascular treatment SummaryBackground. Based on earlier studies, we aimed to determine the quality of life of patients with intracranial aneurysm after their treatment by surgery or embolization and to compare the quality of life of these two groups.Methods. The SF-36 health questionnaire was retrospectively applied to 93 patients with intracranial aneurysm treated with surgery (n=56) or embolization (n=37).Results. The quality of life of some patients was impaired but 50% of patients treated with surgery and 40,5% of patients treated with embolization showed no impairment in any SF-36 domain. The quality of life in the Physical Functioning domain was higher in embolization-treated than in surgery-treated patients.Conclusions. Some patients with intracranial aneurysms treated with surgery or endovascular embolization have an impaired quality of life. Endovascular treatment may cause less limitation in physical function. The quality of life of these patients is affected by numerous factors, in addition to the type of treatment.KEY WORDS: Quality of life. Intracranial aneurysm. Subarachnoid haemorrhage. Surgery. Endovascular. Embolization. IntroducciónEl concepto de calidad de vida ha sido profundamente estudiado desde diferentes disciplinas en los últimos 30 años 25 . En la medicina tradicional solo se consideraban los resultados de una intervención mediante los conceptos de curación, remisión y recurrencia, entre otros 7 . Esta visión de los resultados de una intervención no tiene en cuenta la repercusión que ha tenido la enfermedad en la vida del paciente en diversas áreas como son la familiar, social o laboral. La calidad de vida relacionada con la salud (CVRS) se ha definido como "el valor asig...

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Two-year prospective study of psychosocial outcomes and a cost-analysis of 'treatment-as-usual' versus an 'enhanced' (specialist liaison nurse) service for aneurysmal sub arachnoid haemorrhage (ASAH) patients and families

Cited by 26 publications

References 7 publications

Patients Experience High Levels of Anxiety 2 Years Following Aneurysmal Subarachnoid Hemorrhage

Patients Experience High Levels of Anxiety 2 Years Following Aneurysmal Subarachnoid Hemorrhage

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

Calidad de vida en pacientes con aneurismas intracraneales: cirugía versus tratamiento endovascular

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