Perceived recovery after aneurysmal subarachnoid haemorrhage in individuals with or without depression

Authors

  • Mathilde Hedlund,

    1. Authors:Mathilde Hedlund, RN, PhD Student, Department of Public Health and Caring Sciences and Department of Neuroscience Psychiatry, University Hospital; Maria Zetterling, MD, PhD Student, Department of Neuroscience, Neurosurgery, University Hospital; Elisabeth Ronne-Engstrom, MD, PhD, Associate Professor, Department of Neuroscience, Neurosurgery, University Hospital; Lisa Ekselius, MD, PhD, Professor, Department of Neuroscience Psychiatry, University Hospital; Marianne Carlsson, PhD, Professor, Department of Public Health and Caring Sciences, Uppsala Science Park, Uppsala, Sweden
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  • Maria Zetterling,

    1. Authors:Mathilde Hedlund, RN, PhD Student, Department of Public Health and Caring Sciences and Department of Neuroscience Psychiatry, University Hospital; Maria Zetterling, MD, PhD Student, Department of Neuroscience, Neurosurgery, University Hospital; Elisabeth Ronne-Engstrom, MD, PhD, Associate Professor, Department of Neuroscience, Neurosurgery, University Hospital; Lisa Ekselius, MD, PhD, Professor, Department of Neuroscience Psychiatry, University Hospital; Marianne Carlsson, PhD, Professor, Department of Public Health and Caring Sciences, Uppsala Science Park, Uppsala, Sweden
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  • Elisabeth Ronne-Engstrom,

    1. Authors:Mathilde Hedlund, RN, PhD Student, Department of Public Health and Caring Sciences and Department of Neuroscience Psychiatry, University Hospital; Maria Zetterling, MD, PhD Student, Department of Neuroscience, Neurosurgery, University Hospital; Elisabeth Ronne-Engstrom, MD, PhD, Associate Professor, Department of Neuroscience, Neurosurgery, University Hospital; Lisa Ekselius, MD, PhD, Professor, Department of Neuroscience Psychiatry, University Hospital; Marianne Carlsson, PhD, Professor, Department of Public Health and Caring Sciences, Uppsala Science Park, Uppsala, Sweden
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  • Lisa Ekselius,

    1. Authors:Mathilde Hedlund, RN, PhD Student, Department of Public Health and Caring Sciences and Department of Neuroscience Psychiatry, University Hospital; Maria Zetterling, MD, PhD Student, Department of Neuroscience, Neurosurgery, University Hospital; Elisabeth Ronne-Engstrom, MD, PhD, Associate Professor, Department of Neuroscience, Neurosurgery, University Hospital; Lisa Ekselius, MD, PhD, Professor, Department of Neuroscience Psychiatry, University Hospital; Marianne Carlsson, PhD, Professor, Department of Public Health and Caring Sciences, Uppsala Science Park, Uppsala, Sweden
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  • Marianne Carlsson

    1. Authors:Mathilde Hedlund, RN, PhD Student, Department of Public Health and Caring Sciences and Department of Neuroscience Psychiatry, University Hospital; Maria Zetterling, MD, PhD Student, Department of Neuroscience, Neurosurgery, University Hospital; Elisabeth Ronne-Engstrom, MD, PhD, Associate Professor, Department of Neuroscience, Neurosurgery, University Hospital; Lisa Ekselius, MD, PhD, Professor, Department of Neuroscience Psychiatry, University Hospital; Marianne Carlsson, PhD, Professor, Department of Public Health and Caring Sciences, Uppsala Science Park, Uppsala, Sweden
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Mathilde Hedlund, PhD Student, Department of Public Health and Caring Sciences and Department of Neuroscience Psychiatry, University Hospital, SE-751 85 Uppsala, Sweden. Telephone: +46 18 6115231.
E-mail:mathilde.hedlund@uaspsyk.uu.se

Abstract

Aims.  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.

Background.  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.

Design.  Qualitative descriptive design.

Method.  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.

Results.  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.

Conclusions.  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.

Relevance to clinical practice.  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.

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