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Coping strategies, health-related quality of life and psychiatric history in patients with aneurysmal subarachnoid haemorrhage
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences. Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Neurosurgery.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Public Health and Caring Sciences, Caring Sciences.
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Neuroscience, Psychiatry, University Hospital.
2010 (English)In: Acta Neurochirurgica, ISSN 0001-6268, E-ISSN 0942-0940, Vol. 152, no 8, 1375-1382 p.Article in journal (Refereed) Published
Abstract [en]

Subarachnoid haemorrhage (SAH) reduces health-related quality of life (HRQoL) and increases the risk of psychiatric sequels such as depression and posttraumatic stress disorder. Especially those with a psychiatric history and those using maladaptive coping strategies are at risk for such sequels. The extent to which HRQoL after SAH was related to a history of psychiatric morbidity and to the use of various coping strategies was assessed.

Patients admitted to the Uppsala University Hospital with aneurysmal SAH (n = 59) were investigated prospectively. Seven months after SAH, data were collected using the Structured Clinical Interview for DSM-IV axis I disorders, the Short Form-36 (SF-36) Health Survey and the Jalowiec Coping Scale.

Patients with SAH had lower HRQoL than the general Swedish population in all eight domains of the SF-36. The lower HRQoL was almost entirely in the subgroup with a psychiatric history. HRQoL was also strongly correlated to the use of coping. Physical domains of SF-36 were less affected than mental domains. Those with a psychiatric history used more coping than the remainder with respect to all emotional coping scales. Coping and the presence of a psychiatric history were more strongly related to mental than to physical components of HRQoL.

A psychiatric history and the use of maladaptive emotional coping were related to worse HRQoL, more to mental than to physical aspects.

Place, publisher, year, edition, pages
2010. Vol. 152, no 8, 1375-1382 p.
Keyword [en]
Subarachnoid haemorrhage, Health-related quality of life (HRQoL), Coping, Psychiatric history
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:uu:diva-109760DOI: 10.1007/s00701-010-0673-yISI: 000279704300016OAI: oai:DiVA.org:uu-109760DiVA: diva2:273898
Available from: 2009-10-26 Created: 2009-10-26 Last updated: 2017-12-12Bibliographically approved
In thesis
1. Coping, Psychiatric Morbidity and Perceived Care in Patients with Aneurysmal Subarachnoid Haemorrhage
Open this publication in new window or tab >>Coping, Psychiatric Morbidity and Perceived Care in Patients with Aneurysmal Subarachnoid Haemorrhage
2009 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

Many patients with an aneurysmal subarachnoid haemorrhage (SAH) exhibit difficulties in rehabilitation, even in cases of a good prognosis. The present project investigates this using qualitative methods and standardised outcome measures.

Patients with SAH treated at Uppsala University Hospital between 2002 and 2005 with an expected good prognosis were consecutively included. In addition, nurses working with such patients were interviewed.

Outcome was assessed in terms of perception of care, psychiatric health, coping and health related quality of life (HRQoL).

Qualitative content analyses revealed eight categories, which were divided into two patterns, Confident or Pessimistic perception of recovery, largely on the basis of the presence or absence of depression.

Eighty-three patients were assessed by The Structured Clinical Interview for DSM-IV, Axis I (SCID-I). Forty-one percent fulfilled criteria for any psychiatric disorder seven months after SAH and 45 % presented with a history of lifetime psychiatric morbidity. Logistic regressions indicated that a psychiatric history was related to a higher risk of psychiatric problems seven months after SAH, as well as a lower return to work.

SAH patients had lower HRQoL than the general Swedish population; almost entirely in the subgroup with a psychiatric history prior to the SAH. Those with a psychiatric history used more evasive, fatalistic, emotive and palliative coping strategies associated with inability to handle illness. Multiple regressions revealed that a psychiatric history and use of coping were independently associated with HRQoL, albeit more in the mental than the physical domains.

Qualitative content analyses revealed that nurses viewed patients’ support needs as a process ranging from technological to emotional care. Shortcomings in the communication between nurses in acute and rehabilitation settings on the subject of support were acknowledged.

The results underline the importance of early diagnosis of coexisting psychiatric illness and the need for an intact health care chain.

Place, publisher, year, edition, pages
Uppsala: Acta Universitatis Upsaliensis, 2009. 53 p.
Series
Digital Comprehensive Summaries of Uppsala Dissertations from the Faculty of Medicine, ISSN 1651-6206 ; 496
Keyword
subarachnoid haemorrhage, health related quality of life, depression, nursing care, post traumatic stress disorder, psychiatric disorders, coping
National Category
Nursing
Research subject
Caring Sciences
Identifiers
urn:nbn:se:uu:diva-109761 (URN)978-91-554-7653-3 (ISBN)
Public defence
2009-12-12, Enghoffsalen, Entrance 50, Akademiska sjukhuset, 751 85, Uppsala, 09:15 (Swedish)
Opponent
Supervisors
Available from: 2009-11-19 Created: 2009-10-26 Last updated: 2009-11-19Bibliographically approved

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