Two-year prospective study of psychosocial outcomes and a cost-analysis of 'treatment-as-usual' versus an 'enhanced' (specialist liaison nurse) service for aneurysmal sub arachnoid haemorrhage (ASAH) patients and families.
An 18-month retrospective study of 'treatment-as-usual' of aneurysmal subarachnoid haemorrhage (ASAH, n = 142) used as control to compare prospective study (n = 184) of an 'enhanced' ('Specialist Liaison Nurse'-SLN) service to reduce psychosocial trauma. Consultant notes, Glasgow Coma Scores and 'High Risk' bleeds scores provided clinical data. A standardized patient/carer designed questionnaire provided psychosocial data, plus a cost-analysis. The cohorts were good clinical and social matches. Sixty-five per cent of patients had 'high risk' bleeds, and 81% were Grade 1 and 2 on the GCS, 54% aged less than 55 years, 83% belonged to social classes 1-3 and 32% had school-aged children. Satisfaction with SLN inpatient and discharge care increased significantly, with reduced psychosocial trauma. The SLN produced net 'savings' of pounds sterling 155,000 p.a., from reduced time-off work, medical time and re-admissions. Prospectively, pounds sterling 1.6 + million annual 'savings' were identified on 80% of employed patients returning to work. Long-term dysfunctional stress is not inevitable for most ASAH patients as a SLN is clinically and fiscally cost-effective.
Pritchard
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C
Institute of Health & Community Studies, Bournemouth University and Wessex Neurological Centre, Southampton, UK. colpritchz@hotmail.com
Foulkes
L
L
Lang
D A
DA
Neil-Dwyer
G
G
D000328:Adult; D000368:Aged; D001294:Attitude to Health; D017028:Caregivers; D003153:Community Health Services / Q000592:standards; D003365:Costs and Cost Analysis; D004644:Emotions; D005194:Family Practice / Q000592:standards; D005260:Female; D006304:Health Status; D006760:Hospitalization; D006801:Humans; D008297:Male; D008875:Middle Aged; D024802:Nurse's Role; D009732:Nursing Care / Q000592:standards; D017060:Patient Satisfaction; D011446:Prospective Studies; D012923:Social Class; D013315:Stress, Psychological / Q000191:economics / Q000209:etiology; D013345:Subarachnoid Hemorrhage / Q000191:economics / Q000523:psychology / Q000628:therapy*