Change search
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf
Daily life after Subarachnoid Haemorrhage: Identity construction, patients’ and relatives’ statements about patients’ memory, emotional status and activities of living
Jönköping University, School of Health Science, HHJ, Quality Improvement and Leadership in Health and Welfare.
2012 (English)Doctoral thesis, comprehensive summary (Other academic)
Abstract [en]

The overall aim of this thesis was to describe patients’ experience and reconstruction regarding the onset of, and events surrounding being struck by a Subarachnoid Haemorrhage (SAH), and to describe patients’ and relatives’ views of patients’ memory ability, emotional status and activities of living, in a long-term perspective.

Methods: Both inductive and deductive approaches were used. Nine open interviews were carried out in home settings, in average 1 year and 7 seven months after the patients’ onset, and discourse analysis was used to interpret the data. Eleven relatives and 11 patients, 11 years after the onset, and 15 relatives and 15 patients, 6 years after the onset, participated in two studies. Interviews using a questionnaire with structured questions and memory tests were used to collect data. Fischer’s exact test and Z-scores were used for the statistical analysis.

Results: Patients with experience of a SAH were able to judge their own memory for what happened when they became ill. The reconstruction of the illness event may be interpreted as an identity creating process. The process of meaning-making is both a matter of understanding SAH as a pathological event and a social and communicative matter, where the SAH is construed into a meaningful life history, in order to make life complete (I). Memory problems, changes in emotional status and problems with activities of living were common (II-IV). There was correspondence between relatives’ and patients’ statements regarding the patients’ memory in general and long-term memory. Patients judged their own memory ability better than relatives, compared with results on memory tests. Relatives stated that some patients had meta-memory problems (II). The episodic memory seemed to be well  reserved, both concerning the onset and in the long-term perspective (I, II). There were more problems with social life than with P- and I-ADL (III), and social company habits had changed due to concentration difficulties, mental fatigue, and  patients’ sensitivity to noisy environments and uncertainty (IV). Relatives rated the patients’ ability concerning activities of living and emotional status, and in a similar manner to patients’ statements (III-IV).

Conclusions: The reconstruction of the illness event can be used as a tool in nursing for understanding the patient’s identity-construction. Relatives and patients stated the patients’ memory, emotional status and activities of living in a similar manner, and therefore both patients’ and relatives’ statements can be used as a tool in nursing care, in order to support the patient. However, the results showed: meta-memory problems (relatives’ statements) and that the patients’ judged their own memory ability better than relatives in comparison with results on memory tests. Nevertheless, there was a high degree of concordance between relatives’ and patients’ evaluations concerning patients´ memory ability, emotional status, emotional problems, social company habits and activities of living. Therefore both relatives’ and patients’ statements can be considered to be reliable. However, sometimes the patients and the relatives judge the patients’ memory differently. Consequently, memory tests and formalized dialogues between the patient, the relative and a professional might be required, in order to improve the mutual family relationship in a positive way. Professionals however, must first assume that patients can judge their own memory, emotional status and ability in daily life.

Place, publisher, year, edition, pages
Jönköping: School of Health Sciences , 2012. , 86 p.
Series
Hälsohögskolans avhandlingsserie, ISSN 1654-3602 ; 39
Keyword [en]
SAH, Stroke, Pain, Memory, Decisions, Meaning-making, Identity-construction, Psychological sequelae, Emotional status, Social life, P-and I-ADL, Memory tests, Interviews, Questionnaire
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:hj:diva-19840ISBN: 978-91-85835-38-6 (print)OAI: oai:DiVA.org:hj-19840DiVA: diva2:570181
Supervisors
Available from: 2012-11-16 Created: 2012-11-16 Last updated: 2012-11-26Bibliographically approved
List of papers
1. Identity construction and meaning-making after subarachnoid haemorrhage
Open this publication in new window or tab >>Identity construction and meaning-making after subarachnoid haemorrhage
2010 (English)In: British journal of neuroscience nursing, Vol. 6, no 2, 86-93 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim was to analyse people’s accounts of subarachnoid haemorrhage (SAH) and to describe how they initiate and create meaning for the onset and events surrounding the SAH.

Background: Being struck by a SAH is a dramatic event, often followed byunconsciousness. There is therefore a special need for a patient to try tocreate some kind of meaning for the event during recovery andafterwards.

Method: Nine interviews were carried out in home settings and discourse analysis was used to interpret the data.

Findings: People stricken by SAH seem to be able to judge from memory for when they were becoming ill. Critical events related to SAH were existential threats and existential insights; and time as ‘waiting’ and timeas ‘structuring meaning’. The reconstruction of the illness event may be interpreted as an identity-creating process.

Conclusions: The reconstruction of the illness is a tool that can be used by nurses and other health professionals to understand a patient’s self positioning and identity-construction.

Keyword
Subarachnoid haemorrhage, Illness narratives, Pain, Memory, Meaning-making, Identity construction
National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-14447 (URN)
Available from: 2011-01-27 Created: 2011-01-27 Last updated: 2012-11-16Bibliographically approved
2. Memory ability after subarachnoid haemorrhage: Relatives´and patients´statements in relation to test results
Open this publication in new window or tab >>Memory ability after subarachnoid haemorrhage: Relatives´and patients´statements in relation to test results
2010 (English)In: British Journal of Neuroscience Nursing, ISSN 1747-0307, E-ISSN 2052-2800, Vol. 6, no 8, 383-391 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to describe memory after a subarachnoid haemorrhage (SAH) from the perspective of relatives and patients in two cohorts and also to evaluate the application of relatives' statements as a tool in nursing care and rehabilitation, in order to support the patient. Background: Cognitive sequelae due to SAH are a large disability and may influence the adjustment to daily life. Supporting patients and relatives requires knowledge concerning the patients' memory both from the perspective of patients and relatives. Method: Eleven relatives and 11 patients (Cohort 1), 11 years after the onset of an SAH and 15 relatives and 15 patients (Cohort 2) 6 years after the onset of an SAH, participated in the study. Interview questions and memory tests were used to collect data. Findings: Problems with memory, including meta-memory problems regarding relatives' statements, were common. Relatives and patients stated patients' memory in a similar manner. However, patients' statements concerning their memory corresponded in higher degree with memory test results, in comparison with relatives' statements. Conclusions: Relatives' and patients' statements are useful as tools in nursing care and rehabilitation. However, from results showing meta-memory problems and that patients' statements concerning their memory corresponded better with memory test results (in comparison with relatives' statements), it is vital to offer patients memory tests in order to prevent complications in mutual family relationships.

National Category
Nursing
Identifiers
urn:nbn:se:hj:diva-14446 (URN)
Available from: 2011-01-27 Created: 2011-01-27 Last updated: 2017-09-20Bibliographically approved
3. Subarachnoid haemorrhage has long-term effects on social life
Open this publication in new window or tab >>Subarachnoid haemorrhage has long-term effects on social life
2011 (English)In: British Journal of Neuroscience Nursing, ISSN 1747-0307, E-ISSN 2052-2800, Vol. 7, no 1, 429-435 p.Article in journal (Refereed) Published
Abstract [en]

Aim: The aim of this study was to describe activities of living after a subarachnoid haemorrhage (SAH) from the perspective of relatives and patients in two cohorts and to evaluate the application of relatives’ statements, as a tool in nursing care, in order to support the patient.

Background: Memory problems after SAH are common according to patients’ and relatives’ statements and memory test results. This may influence the adjustment to daily life. Supporting patients and relatives requires knowledge concerning the activities of daily living from the perspective of both patients and relatives.

Method:Eleven relatives and 11 patients (cohort 1), 11 years after the onset of an SAH and 15 relatives and 15 patients (cohort 2) 6 years after the onset of an SAH participated in the study. Interview questions and memory tests were used to collect data.

Findings:Problems with activities of daily living were common and patients had more problems with social life than with personal and instrumental activites. The change in social company habits were due to emotional problems. Patients’ statements about problems with activities of living corresponded to results from patients’ memory tests and patients’ statements.

Conclusions: Relatives’ and patients’ statements are useful as tools in nursing care. Introducing fromalized dialogues and memory tests would improve the after care for this group of patients and improve their future family relationships.

Place, publisher, year, edition, pages
MA Healthcare, 2011
Keyword
subarachnoid haemorrhage, memory tests, daily life, interview questions, activities of living
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-19837 (URN)
Available from: 2012-11-16 Created: 2012-11-16 Last updated: 2017-11-28Bibliographically approved
4. Social company habits and emotional status following a Subarachnoid Haemorrhage: A study based on relatives´ and patients´ statements, in a long term perspective
Open this publication in new window or tab >>Social company habits and emotional status following a Subarachnoid Haemorrhage: A study based on relatives´ and patients´ statements, in a long term perspective
Show others...
2012 (English)In: British Journal of Nursing, ISSN 0966-0461, E-ISSN 2052-2819Article in journal (Refereed) Submitted
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:hj:diva-19838 (URN)
Available from: 2012-11-16 Created: 2012-11-16 Last updated: 2017-12-07Bibliographically approved

Open Access in DiVA

fulltext(4807 kB)834 downloads
File information
File name FULLTEXT01.pdfFile size 4807 kBChecksum SHA-512
61fda67ad48c3996c7c4a38adb0b6f181d48dedf4ec2d010173b6dfe6f412e0637d39252efe246c7e37ade7c472e4742598f2c20faa17839dd4383a081794ca2
Type fulltextMimetype application/pdf

By organisation
HHJ, Quality Improvement and Leadership in Health and Welfare
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar
Total: 834 downloads
The number of downloads is the sum of all downloads of full texts. It may include eg previous versions that are now no longer available

isbn
urn-nbn

Altmetric score

isbn
urn-nbn
Total: 594 hits
CiteExportLink to record
Permanent link

Direct link
Cite
Citation style
  • apa
  • ieee
  • modern-language-association-8th-edition
  • vancouver
  • Other style
More styles
Language
  • de-DE
  • en-GB
  • en-US
  • fi-FI
  • nn-NO
  • nn-NB
  • sv-SE
  • Other locale
More languages
Output format
  • html
  • text
  • asciidoc
  • rtf