Alice Storey, Russell Sheldrick, Louise Dulhanty, Nicolo Zarotti

Study evaluates group support in SAH

Recovery after a subarachnoid haemorrhage (SAH) is tough – but survivors say sharing their experiences in a group support programme, alongside health specialists, can help them come to terms with loneliness, tiredness and other problems which affect their return to daily life.

Clinicians and researchers at Salford Royal Hospital have carried out a qualitative service evaluation with patients to explore their experiences of attending a multidisciplinary group-based programme of support. They will use the resulting feedback to improve the programme.

SAH accounts for one in 20 of all strokes. Medical treatment of SAH has improved and more people are being discharged home, but survivors face problems such as fatigue, depression, anxiety, and cognitive issues such as reduced attention span and memory loss.

Sharing experiences

The programme was led by a multidisciplinary team (MDT) consisting of SAH Consultant Nurse Louise Dulhanty, Consultant Clinical Neuropsychologist Dr Russell Sheldrick, Senior Assistant Psychologist Alice Storey, and Cognitive and Personal Wellbeing Practitioner Maggie Mooney. It took place at the Brain and Spinal Injury Centre (BASIC) near Salford Royal and involved small groups of SAH survivors sharing their experiences over seven one-hour sessions. These revolved around a number of unmet needs in SAH survivors identified by previous research at Salford Royal. Talks and advice from different specialists involved in stroke care, including a neurosurgeon and an occupational therapist, were also featured in specific sessions.

Alice Storey, who led the qualitative service evaluation under the supervision of Academic and Clinical Psychologist Dr Nicolò Zarotti, explained: “People who survive an SAH often face lasting health challenges, including physical disability, fatigue, cognitive problems, psychological difficulties, and reduced quality of life. We know from past research that groups offering education and peer support have had a positive impact in other conditions, but there’s little evidence for those with SAH.”

Key findings

After the programme, Ms Storey interviewed 12 participants about their experience and carried out a thematic analysis of the resulting data, which led to four key findings:

  • Lack of communication, fear, loneliness, and cognitive impairments may act as barriers to accessing support after a SAH.
  • Acceptance and adjustment, multidisciplinary help, and psychological support may help rehabilitation.
  • Participants appreciated sharing their experiences – one said: “It’s a really lonely experience, a brain haemorrhage, and to actually be in the room of people who have gone through the same and doing other things, it just made it all more real and easier.”
  • Navigating a group format can help develop feelings of connectedness – as another participant said: “In the very first meeting we were passing the box of tissues around, and I think it gave people the confidence to open up about their own experience. So, it’s much better in a group. I would have struggled more on a one to one to articulate what I wanted to say.”

The findings of the evaluation have been published in the journal Disability and Rehabilitation.

Senior authors Louise Dulhanty and Dr Nicolò Zarotti said the team will now look at making sure there’s effective communication and efficient referral routes to support when SAH survivors leave hospital. The team will also develop  written materials to accompany the programme as a reminder for participants of the information provided.

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