title: Determinants of health-related quality of life after aneurysmal subarachnoid hemorrhage: a systematic review.
abstract: OBJECTIVE
  Many persons with subarachnoid hemorrhage (SAH) from a ruptured intracranial aneurysm recover to functional independence but nevertheless experience reduced quality of life (QoL). The aim of this study was to summarize the evidence on determinants of reduced QoL in this diagnostic group.
  
  
  METHODS
  Databases PubMed, PsychINFO, and CINAHL were used to identify empirical studies reporting on quantitative relationships between possible determinants and QoL in persons with aneurysmal SAH and published in English. Determinants were classified using the International Classification of Functioning, Disability and Health (ICF).
  
  
  RESULTS
  Twenty studies met the inclusion criteria for this review, in which 13 different HRQoL questionnaires were used. Determinants related to Body Structure & Function (clinical condition at admission, fatigue, and disturbed mood), Activity limitations (physical disability and cognitive complaints), and Personal factors (female gender, higher age, neuroticism, and passive coping) are consistently related to worse HRQoL after aneurysmal SAH. Treatment characteristics were not consistently related to HRQoL.
  
  
  CONCLUSIONS
  This study identified a broad range of determinants of HRQoL after aneurysmal SAH. The findings provide clues to tailor multidisciplinary rehabilitation programs. Further research is needed on participation, psychological characteristics, and environmental factors as determinants of HRQoL after SAH.
authors.affiliation: Rudolf Magnus Institute of Neuroscience and Centre of Excellence for Rehabilitation Medicine, University Medical Centre Utrecht and Rehabilitation Centre De Hoogstraat, P.O. Box 85500, 3508 GA, Utrecht, The Netherlands.
authors.forename: P E C A
authors.initials: PE
authors.lastname: Passier
authors.forename: J M A
authors.initials: JM
authors.lastname: Visser-Meily
authors.forename: G J E
authors.initials: GJ
authors.lastname: Rinkel
authors.forename: E
authors.initials: E
authors.lastname: Lindeman
authors.forename: M W M
authors.initials: MW
authors.lastname: Post
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D005221:Fatigue / Q000523:psychology; D005260:Female; D006304:Health Status; D006801:Humans; D008297:Male; D008875:Middle Aged; D019964:Mood Disorders / Q000523:psychology; D017063:Outcome Assessment, Health Care; D011788:Quality of Life; D018434:Sickness Impact Profile; D013345:Subarachnoid Hemorrhage / Q000523:psychology* / Q000534:rehabilitation*; D011795:Surveys and Questionnaires