くも膜下出血後の認知障害に対する代償戦略：患者の視点

Cognitive complaints following aneurysmal subarachnoid hemorrhage (aSAH) are common and often result in a decreased quality of life. Many patients use strategies to compensate for cognitive complaints in the long-term after aSAH, but it remains unclear which strategies are used. We aimed to determine and classify compensation strategies for cognitive complaints after aSAH.

This study was conducted between May 2020 and November 2021. All aSAH patients who visited the outpatient aftercare clinic of our tertiary referral hospital between 2016 and 2019 were contacted to participate. We asked participants to fill out a questionnaire, and we collected data from patient files. We retrieved from questionnaires which strategies were commonly used in the years after aSAH to compensate for cognitive complaints, and used Wilson's model of compensation as an existing theoretical framework to classify these strategies.

Of 166 eligible patients, 81 (49%) patients returned the questionnaire at a median of 46 months after aSAH, of whom 77 (95%) had at least one cognitive complaint. We identified 576 compensation strategies, which we categorized into eight subthemes of strategies: increased time and effort, increased rest before/after activity, removal of distractor, use of alternative cognitive functions, use of external aids, use of others, adjust to reduced cognitive performance, accept reduced cognitive performance.

The results of our study show that numerous compensation strategies are used to compensate for cognitive complaints after aSAH. The identified strategies may help patients to select a strategy that best matches their personal needs and preferences.