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Sálfélagsleg líðan fullorðinna einstaklinga eftir innanskúmsblæðingu: kerfisbundið fræðilegt yfirlit

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Authors
Inga Steinþóra Guðbjartsdóttir
Helga Jónsdóttir
Marianne E. Klinke
Issue Date
2019-06-06

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Other Titles
Psychosocial functioning in adults after subarachnoid hemorrhage: A systematic review of the literature
Citation
Sálfélagsleg líðan fullorðinna einstaklinga eftir innanskúmsblæðingu: kerfisbundið fræðilegt yfirlit. 2019, 95(2):87-109 Tímarit hjúkrunarfræðinga
Abstract
Tilgangur: Sjálfsprottin innanskúmsblæðing (SIB) er kölluð heila - blóðfall yngra fólksins. Sálfélagsleg vanlíðan einstaklinga sem fengið hafa SIB getur valdið þeim erfiðleikum með að ná takti í lífnu, jafnvel mörgum árum eftir áfallið. Þrátt fyrir fjölda rannsókna skortir kerfisbundna samantekt á þeim vanda sem einstaklingar með SIB standa frammi fyrir auk þekkingar á bestu hugsanlegu úrræðum. Tilgangur þessa kerfisbundna fræðilega yfirlits var þríþættur: Að samþætta þekkingu um þætti sem hafa áhrif á sálfélagslega líðan SIB-sjúklinga meira en þremur mánuðum eftir áfallið; að lýsa tíðni algengra sálfé lagslegra einkenna; koma auga á nýja þekkingu og hugsanlegar íhlutanir fyrir hjúkrun. Aðferð: Kerfisbundið fræðilegt yfirlit. Stuðst var við aðferð stofnunar Joanna Briggs (JBI) og PRISMA-yfirlýsinguna við framsetningu niðurstaðna. Leitað var í PubMed og CINAHL að birtum greinum frá janúar 2007 til nóvember 2017. Gátlistar frá JBI voru notaðir til þess að meta veikleika frumrannsókna. Niðurstöður voru samþættar með „matrix“-aðferðinni. Niðurstöður: Þrjátíu og þrjár greinar voru teknar með í yfirlitið þar sem 5073 einstaklingar með SIB voru rannsakaðir. Sálfélagsleg vandamál voru til staðar hjá yfir 50% þátttakenda á öllum tímapunktum: frá þremur mánuðum og upp í 20 ár eftir áfallið. Fjögur megin viðfangsefni voru greind: (1) Skert lífsgæði, (2) kvíði/þunglyndi, (3) áfallastreituröskun, ótti og sálfélagsleg vanlíðan og (4) breytt atvinnuþátttaka, félagslíf og samfélagslegar þarfir. Þættir tengdir við SIB voru meðal annars skortur á nánd við maka, tjáskiptavandamál, endurtekin upprifjun á áfalli, vitsmunaleg skerðing og hegðunartruflanir. Forspárgildi sálfélagslegra vandamála voru meðal annars kvenkyn, yngri aldur við áfallið, minni menntun og óstöðug hjú skaparstaða. Ályktanir : Niðurstöður samantektarinnar má nýta við gerð kerfisbundins mats, eftirfylgni og upplýsingagjafar til sjúklinga með SIB og fjölskyldna þeirra . Vegna hárrar tíðni og alvarlegra afleiðinga sálfélagslegra vandamála er þörf á að heilbrigðisstarfsfólk bregðist markvisst við þeim vanda sem sjúklingar með SIB standa frammi fyrir.
Aim: Subarachnoid hemorrhage (SAH) has been labeled the “stroke of the younger population”. Due to psychosocial problems, patients with SAH oRen encounter di|culties in regaining a normal pace in life, even years aRer the event. Numerous studies have addressed the topic, but an overview of challenges and solutions is warranted. xerefore, we set out to synthesize knowledge about psychosocial functioning of patients with SAH three months or more aRer the bleed, describe the prevalence of common psychosocial symptoms, and identify implications for nursing practice and research. Method: Systematic literature review guided by the Joanna Briggs Institute (JBI) Reviewer’s handbook. xe PRISMA statement was used to present the results. PubMed and CINAHL were searched for articles published from January 2007 until November 2017. JBI checklists were used to assess weaknesses of the primary studies. Data were synthesized with “the matrix method”. Results:xirty-three articles were included in the review with 5073 patients participating. Psychosocial problems were present in > 50% of the participants at all time-points; from three months aRer SAH until 20 years thereaRer. Four categories were identiQed: (1) Decreased quality of life, (2) anxiety/depression, (3) post-traumatic stress, fear and psychosocial distress, and (4) change in employment, social life and life-space mobility. Psychosocial problems were among others associated with lack of intimacy with spouses, communication problems, being single, recurrent experience of the incident, cognitive and behavioral problems. Predictive factors for psychosocial distress were being; female, younger, lower educated, and in an unstable relationship. Conclusion:xe results can be used to develop new systematic me - thods of assessment and follow-up, and also to inform patients and their families about possible psychosocial challenges. xe high frequency and serious consequences of psychosocial problems under - score an urgent need for healthcare professionals to respond to the challenges that patients with SAH are confronted with.
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https://www.hjukrun.is/timaritid/bladasafn/2.-tbl.-2019/
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Icelandic Journal Articles (Peer Reviewed)

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