Department of Neurology, Canisius Wilhelmina Hospital, Nijmegen, the Netherlands.
Department of Neurosurgery, Radboud University Medical Center, Nijmegen, the Netherlands.
BMC Neurol. 2023 Jun 19;23(1):236. doi: 10.1186/s12883-023-03280-w.
In patients with mild disabilities after aneurysmal subarachnoid hemorrhage (aSAH), invisible symptoms might be easily overlooked during consultations in the outpatient clinic. We hypothesize that the Questionnaire for the Screening of Symptoms in aneurysmal Subarachnoid Hemorrhage (SOS-SAH), a disease-specific patient-reported outcome measure, might aid in screening for symptoms after aSAH. The objective of this explorative study is to evaluate the perceived impact of using the SOS-SAH in daily clinical practice for patients after aSAH, as well as to explore potential barriers to further implementation.
This multi-method study consists of a quantitative and a qualitative component. To evaluate differences in quality of care, a patient experience survey was sent to patients receiving usual care and to patients who received the SOS-SAH. A multiple linear regression model was applied, with the intervention group and case mix adjusters as independent variables. We described differences in the number of symptoms discussed between patients receiving usual care and those receiving care post-implementation. Following implementation, 16 patients and 6 healthcare professionals were interviewed about their perceptions concerning the impact of and barriers to using the SOS-SAH. A thematic analysis was performed to identify the main themes.
The survey did not reveal any differences between the usual-care group and the post-implementation group on the scales of the patient experience survey. After implementation of the SOS-SAH, the number of symptoms discussed during consultation did not increase. The interviews suggest that the SOS-SAH may improve the preparation of patients by providing them with greater insight into their complaints and by raising issues for the consultation. It could also enhance the structure and efficiency of consultation, in addition to improving communication about issues that matter to patients. All patients and healthcare professionals recommended continuing the use of the SOS-SAH in daily practice.
Although no quantitative improvements were found in patient experience and symptoms discussed during consultation, implementation of the SOS-SAH could aid in screening for symptoms in patients after aSAH, and it might have a positive influence on patient preparation, while helping to structure consultations between patients and healthcare professionals.
在患有轻度残疾的动脉瘤性蛛网膜下腔出血（aSAH）患者中，门诊就诊时可能很容易忽略那些隐形症状。我们假设，专门用于筛查动脉瘤性蛛网膜下腔出血症状的患者报告结局测量工具——症状筛查问卷（SOS-SAH），可能有助于筛查 aSAH 后的症状。本探索性研究的目的是评估在 aSAH 后患者的日常临床实践中使用 SOS-SAH 的感知影响，以及探索进一步实施的潜在障碍。
本多方法研究包括定量和定性两个部分。为了评估护理质量的差异，向接受常规护理的患者和接受 SOS-SAH 的患者发送了患者体验调查。应用多元线性回归模型，将干预组和病例组合调整器作为自变量。我们描述了接受常规护理的患者和接受实施后护理的患者之间讨论的症状数量的差异。在实施后，对 16 名患者和 6 名医护人员进行了关于他们对使用 SOS-SAH 的影响和障碍的看法的访谈。进行了主题分析以确定主要主题。
调查未显示常规护理组和实施后组在患者体验调查量表上的任何差异。在实施 SOS-SAH 后，咨询期间讨论的症状数量并未增加。访谈表明，SOS-SAH 通过使患者更深入地了解自己的投诉并提出咨询问题，从而可能改善患者的准备情况。它还可以增强咨询的结构和效率，同时改善与患者相关的问题的沟通。所有患者和医护人员都建议在日常实践中继续使用 SOS-SAH。
尽管在患者体验和咨询期间讨论的症状方面未发现定量改善，但实施 SOS-SAH 可能有助于筛查 aSAH 后的症状，并且可能对患者准备产生积极影响，同时帮助患者与医护人员之间的咨询结构。
