Dissertation
OSCILLATING BETWEEN GRATITUDE AND FEAR: LIVED EXPERIENCE OF ANEURYSMAL SUBARACHNOID HEMORRHAGE SURVIVORS AND HEALTH RELATED QUALITY OF LIFE
Washington State University
Doctor of Philosophy (PhD), Washington State University
01/2021
DOI:
https://doi.org/10.7273/000005408
Handle:
https://hdl.handle.net/2376/118996
Abstract
Objective: Aneurysmal subarachnoid hemorrhage (ASAH) is a devastating stroke that affects young adults at a mean age of 55 and mortality rate of 32%. Those who survive have prolonged hospital stays and are subjected to multiple clinical adverse events including hydrocephalus, rebleeding, vasospasm, and delayed cerebral ischemia. Long-term consequences affect physical, neuro-cognitive, psychological, and social aspects of life. The purpose of this study was to describe the lived experiences of ASAH survivors and their health-related quality of life post discharge.Methods: This study utilized Husserl’s descriptive phenomenology methodology. Participants were recruited from an academic medical center outpatient neurosurgery clinic. A semi-structured interview guide and biodemographic background questionnaire guided data collection. Verbatim texts were analyzed according to Giorgi five-step method. The City of Hope Health-Related Quality of Life Theoretical Model gave structure to open-ended interviews, literature review, and for synthesis of results.
Results: Characteristics of the 16 participants included a median age of 56 years, predominantly female (81%), and six weeks to nine years since aneurysm rupture. Three major qualitative themes were uncovered that explained the structure of the general experience: unexpected sudden upheaval of health and wellbeing, unfolding calamity after surviving the ruptured aneurysm, and the journey of rebuilding and regaining one’s life through the emergence over time of a new normal; with the overarching central theme being gratitude for second chance at life in the midst of living in daily fear of recurrence. Salient experiences reported by participants included psychological trauma, uncertainty, change in social relationships, and being unprepared for life after discharge. Other experiences discovered were difficulty in finding resources, fear of recurrence, social support as critical, and spirituality as a protective factor for wellbeing.
Conclusion: Dimensions of the City of Hope Health-Related Quality of Life Model surfaced as essential, describing life after ASAH, when compared to the study’s conceptual model. The results highlight the need for nurse-developed comprehensive post discharge support services, programs acknowledging the salience of all dimensions of health-related quality of life, and matching data-based standardized interventions to core sets of patient-reported short- and long-term outcomes.
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Details
- Title
- OSCILLATING BETWEEN GRATITUDE AND FEAR: LIVED EXPERIENCE OF ANEURYSMAL SUBARACHNOID HEMORRHAGE SURVIVORS AND HEALTH RELATED QUALITY OF LIFE
- Creators
- Bernice G Gulek-Bakirci
- Contributors
- Mel R Haberman (Advisor)Gail Oneal (Committee Member)Lois James (Committee Member)
- Awarding Institution
- Washington State University
- Academic Unit
- College of Nursing
- Theses and Dissertations
- Doctor of Philosophy (PhD), Washington State University
- Publisher
- Washington State University
- Number of pages
- 351
- Identifiers
- 99900599557301842
- Language
- English
- Resource Type
- Dissertation