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

Abstract

Over the last decade there has been an increasing awareness that psychosocial problems may persist in patients who have made apparently good recoveries after aneurysmal subarachnoid haemorrhage (ASAH). The caregivers of these patients are often relatives and it is becoming apparent that these carers frequently suffer psychosocial stress with associated morbidity. Previous studies have looked primarily at patients and few have included carers. We exclusively studied carers using simple validated questionnaires. We measured the effect on general and psychosocial health of the carers of patients treated for ASAH, 2-3 years after discharge. The majority of the carers (88.1%) were close relatives; 53.8% were experiencing social or emotional stress and 46.4% of these felt completely overwhelmed. The level of stress correlated positively with management complications, but not site of aneurysm or other aspects of treatment. We conclude that there is an argument for priority assistance for those carers predicted to be vulnerable to stress.

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

“…This is not surprising. Mezue et al (28) describe that after hospital discharge, relations between patients with aSAH and significant others are in a "honeymoon period." But with time, subtle cognitive, social, and emotional difficulties may place stress on the significant others and affect relationships.…”

Posttraumatic stress disorder in the family and friends of patients who have suffered spontaneous subarachnoid hemorrhage

“…

C onsidering the life-threatening nature of spontaneous SAH and its dramatic clinical presentation and neuropsychological sequelae, 45 it is understandable that overwhelming stress and distress can be experienced not only by the surviving patient, but also by his or her family and friends. 9,21,23,24,29,37,38 In fact, SOs have reported persistent psychiatric symptoms with anxiety, 23,37 depression, 9,37 stress, 4,21,22,29,37,39 and sleep disturbance 29 among the most prominent. Moreover, these difficulties are not experienced solely by the friends and relatives of patients with a poor outcome.

…”

“…9,21,23,24,29,37,38 In fact, SOs have reported persistent psychiatric symptoms with anxiety, 23,37 depression, 9,37 stress, 4,21,22,29,37,39 and sleep disturbance 29 among the most prominent. 4,9,21,22,24,29,37,39,40,46 Interestingly, SOs can have even higher levels of emotional distress than the patient. 4,9,21,22,24,29,37,39,40,46 Interestingly, SOs can have even higher levels of emotional distress than the patient.…”

Re-evaluating the National Subarachnoid Haemorrhage study (2006) from a Patient-Related-Outcome-Measure perspective: comparing fiscal outcomes of Treatment-as-Usual with an enhanced service

“…14,21 Although SAH patients may make a good physical recovery, they might be off work for 6,9,12 or more months after discharge, often with a considerable degree of distress to patients and family. 5,10,14,18 These outcomes cannot be ignored; the issues remain high on patients and carers agendas, 11,13 they give the patient a 'voice' and provide the epitome of PROM.…”

“…[3][4][5][6][7] These studies examined some quality of life measures in regards to the sequel of subarachnoid haemorrhage (SAH), but with some notable exceptions, few actively involved the patient's carers in the analysis. [7][8][9][10][11][12][13][14] The relatively narrow hospital/service focus on outcomes is no longer sufficient as in the proposed re-validation of consultants Patient-Related-Outcome-Measures (PROM) will be included in the assessment.…”