Department of Public Health and Caring Sciences and Department of Neuroscience Psychiatry, University Hospital, SE-751 85 Uppsala, Sweden.
J Clin Nurs. 2010 Jun;19(11-12):1578-87. doi: 10.1111/j.1365-2702.2009.02940.x. Epub 2010 Apr 5.
The aims of the study were to describe what patients with no or only minor neurological deficits after aneurysmal subarachnoid haemorrhage (SAH) perceived to be important for recovery, and perceived consequences of the illness.
Quantitative studies indicates unfavourable outcomes after aneurysmal SAH, concerning for example mental health and return to everyday life, among patients expected to recover completely. Thus, it is important to investigate the perceptions of patients and to give them the opportunity to communicate what they consider important for recovery.
Qualitative descriptive design.
Semi-structured interviews with 20 aneurysmal subarachnoid haemorrhagic patients were conducted approximately 12 months after the onset. Analyses were carried out in two steps, beginning with a qualitative content analysis. Due to the findings in the initial content analysis, a structured clinical interview for psychiatric disorders was used as a second step to verify the presence or absence of depression in the participants.
Two patterns were identified. One pattern revealed that informants without depression experienced a 'confident perception of recovery', which included perceptions of meaningfulness. Another pattern revealed that depressed informants experienced a 'pessimistic perception of recovery', which included perceptions of hopelessness. Expectations regarding care after departure from the neurointensive care unit were not met.
Individuals suffering from depression after aneurysmal SAH have a pessimistic view of their recovery in contrast to those without depression. These findings highlight the importance of better recognition and treatment of depression in the aftermath of SAH.
These findings highlight the importance of better recognition and treatment of depression after aneurysmal SAH, where nurses play an active role. Nurses should seek to take actions to better meet patient's needs after departure from neurointensive care units.
本研究旨在描述那些在蛛网膜下腔出血（SAH）后没有或仅有轻微神经功能缺损的患者认为对康复重要的内容，并了解他们对疾病的认知后果。
定量研究表明，SAH 患者的预后并不乐观，例如心理健康和重返日常生活等方面，这对于那些预计能完全康复的患者来说是令人担忧的。因此，了解患者的认知并给予他们机会来交流他们认为对康复重要的内容是很重要的。
定性描述性设计。
对 20 例蛛网膜下腔出血患者进行半结构式访谈，访谈时间约在发病后 12 个月。分析分为两步进行，首先进行定性内容分析。由于初始内容分析的结果，第二步使用了用于精神障碍的结构化临床访谈，以验证参与者是否存在抑郁。
确定了两种模式。一种模式表明，无抑郁的患者表现出“对康复充满信心”的认知，其中包括对生活有意义的认知。另一种模式则表明，抑郁的患者表现出“对康复感到悲观”的认知，其中包括对未来感到无望的认知。他们对离开神经重症监护病房后的护理期望没有得到满足。
与无抑郁的患者相比，患有 SAH 后抑郁的患者对康复的看法更为悲观。这些发现突出了在 SAH 后更好地识别和治疗抑郁的重要性。
这些发现强调了在 SAH 后更好地识别和治疗抑郁的重要性，护士在其中发挥着积极的作用。护士应该努力采取行动，更好地满足患者离开神经重症监护病房后的需求。
