Post-discharge Nursing Care Needs and Problems of the Patients with Spontaneous Subarachnoid Hemorrhage who Have Undergone Therapeutic Intervention

Abstract

Background

Spontaneous subarachnoid hemorrhage (sSAH) is a neurologic emergency characterized by the extravasation of blood into the subarachnoid space. The patients who had therapeutic intervention may face many problems after their discharge from the hospital, which can be a burden both on the patient and the caregiver. To understand the needs completely, it is necessary to comprehend the problems the patients and caregivers face after discharge related to nursing care. This could lead to improvements in functional status and quality of life.

Objectives

To identify the nursing care needs and problems of the patients with sSAH who have undergone therapeutic intervention follow-up in tertiary care center Chandigarh.

Method

A qualitative narrative study was conducted on 21 participants (15 patients paired with caregivers and six health care workers) enrolled through the purposive sampling technique. Using an interview guide, patients’ problems and nursing care needs were identified from patients, caregivers, and health care workers (HCWs). Interviews were documented after having informed written consent from participants. Ethical clearance was taken from the institute committee.

Results

Various problems were reported by the patients, caregivers, and HCWs. The problems and nursing care needs were grouped under various domains: the physical domain includes headache, rigidity, fatigue, difficulty in the activity of daily living, and many more. The psychological domain has anger, altered memory, concentration, and so on. The problems under the social domain were, not interested in socialization, loss/change of job, disturbing role and responsibility, and so on. The spiritual domain includes decreased/increased faith in God, an inability to practice rituals. Poor therapeutic compliance includes lack of compliance to medical treatment and loss of follow-up. The care need includes a lack of caring skills, knowledge deficit among many. Caregivers reported an increase in burden, disturbed family, financial issues, and lack of caring skills.

Conclusion

The study found various problems and nursing care needs under seven domains, that is, physical, psychological, social, spiritual, poor therapeutic compliance, care needs, and challenges faced by caregivers, which can be considered during the transition phase of patients with sSAH and may guide the health care worker in the provision of holistic care.