Postcomatose unawareness/vegetative state following severe brain injury: a content methodology. 1997

D L Duff, and D L Wells
Centennial College of Applied Arts and Technology, Scarborough, Ontario, Canada.

Postcomatose unawareness/vegetative state (PCU/VS) is an altered state of consciousness that may follow coma. It is characterized by wakefulness without awareness of self or the environment. While most frequently associated with trauma, it is also associated with anoxia, vascular injury or encephalitis. In this article, the clinical phenomenon of PCU/VS is explored using the content methodology process (CMP) in order to explicate content for nursing practice. There are five steps in the process: literature review, identification of the characteristic features and patient behaviors associated with PCU/VS, description of the specific abilities that are affected, formulation of nursing assessment and intervention approaches, and evaluation of these approaches in clinical practice and research. In this article, there is an extensive review and analysis of the literature related to PCU/VS. Substantive nursing knowledge was developed using the CMP. It was determined that the Freeman Questionnaire and the Sensory Stimulation Assessment Measure are appropriate tools to assess the interpretative abilities of patients with PCU/VS during the acute care period. Sensory regulation techniques that are appropriate for use during patient care to promote the recovery of cognitive abilities were identified. Both the recommended tools and the intervention approaches require further validation in empirical research.

UI MeSH Term Description Entries
D009730 Nursing Assessment Evaluation of the nature and extent of nursing problems presented by a patient for the purpose of patient care planning. Nursing Protocols,Assessment, Nursing,Protocols, Nursing,Assessments, Nursing,Nursing Assessments,Nursing Protocol,Protocol, Nursing
D010347 Patient Care Planning Usually a written medical and nursing care program designed for a particular patient. Nursing Care Plans,Goals of Care,Plans, Nursing Care,Care Goal,Care Goals,Care Plan, Nursing,Care Planning, Patient,Care Plans, Nursing,Nursing Care Plan,Plan, Nursing Care,Planning, Patient Care
D001930 Brain Injuries Acute and chronic (see also BRAIN INJURIES, CHRONIC) injuries to the brain, including the cerebral hemispheres, CEREBELLUM, and BRAIN STEM. Clinical manifestations depend on the nature of injury. Diffuse trauma to the brain is frequently associated with DIFFUSE AXONAL INJURY or COMA, POST-TRAUMATIC. Localized injuries may be associated with NEUROBEHAVIORAL MANIFESTATIONS; HEMIPARESIS, or other focal neurologic deficits. Brain Lacerations,Acute Brain Injuries,Brain Injuries, Acute,Brain Injuries, Focal,Focal Brain Injuries,Injuries, Acute Brain,Injuries, Brain,Acute Brain Injury,Brain Injury,Brain Injury, Acute,Brain Injury, Focal,Brain Laceration,Focal Brain Injury,Injuries, Focal Brain,Injury, Acute Brain,Injury, Brain,Injury, Focal Brain,Laceration, Brain,Lacerations, Brain
D003937 Diagnosis, Differential Determination of which one of two or more diseases or conditions a patient is suffering from by systematically comparing and contrasting results of diagnostic measures. Diagnoses, Differential,Differential Diagnoses,Differential Diagnosis
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D015399 Nursing Research Research carried out by nurses, generally in clinical settings, in the areas of clinical practice, evaluation, nursing education, nursing administration, and methodology. Research, Nursing
D018458 Persistent Vegetative State Vegetative state refers to the neurocognitive status of individuals with severe brain damage, in whom physiologic functions (sleep-wake cycles, autonomic control, and breathing) persist, but awareness (including all cognitive function and emotion) is abolished. Minimally Conscious State,Permanent Vegetative State,Post-Traumatic Vegetative State,Vegetative State, Persistent,PVS (Persistent Vegetative State),Persistent Unawareness State,Post-Comatose Unawareness State,Post-Traumatic Unawareness State,Postcomatose Unawareness State,Posttraumatic Unawareness State,Prolonged Post-Traumatic Unawareness,Transient Vegetative State,Vegetative State,Minimally Conscious States,PVSs (Persistent Vegetative State),Permanent Vegetative States,Persistent Unawareness States,Persistent Vegetative States,Post Comatose Unawareness State,Post Traumatic Unawareness State,Post Traumatic Vegetative State,Post-Comatose Unawareness States,Post-Traumatic Unawareness States,Post-Traumatic Unawareness, Prolonged,Post-Traumatic Unawarenesses, Prolonged,Post-Traumatic Vegetative States,Postcomatose Unawareness States,Posttraumatic Unawareness States,Prolonged Post Traumatic Unawareness,Prolonged Post-Traumatic Unawarenesses,State, Minimally Conscious,State, Permanent Vegetative,State, Persistent Unawareness,State, Persistent Vegetative,State, Post-Comatose Unawareness,State, Post-Traumatic Unawareness,State, Post-Traumatic Vegetative,State, Postcomatose Unawareness,State, Posttraumatic Unawareness,State, Transient Vegetative,State, Vegetative,States, Minimally Conscious,States, Permanent Vegetative,States, Persistent Unawareness,States, Persistent Vegetative,States, Post-Comatose Unawareness,States, Post-Traumatic Unawareness,States, Post-Traumatic Vegetative,States, Postcomatose Unawareness,States, Posttraumatic Unawareness,States, Transient Vegetative,States, Vegetative,Transient Vegetative States,Unawareness State, Persistent,Unawareness State, Post-Comatose,Unawareness State, Post-Traumatic,Unawareness State, Postcomatose,Unawareness State, Posttraumatic,Unawareness States, Persistent,Unawareness States, Post-Comatose,Unawareness States, Post-Traumatic,Unawareness States, Postcomatose,Unawareness States, Posttraumatic,Unawareness, Prolonged Post-Traumatic,Unawarenesses, Prolonged Post-Traumatic,Vegetative State, Permanent,Vegetative State, Post-Traumatic,Vegetative State, Transient,Vegetative States,Vegetative States, Permanent,Vegetative States, Persistent,Vegetative States, Post-Traumatic,Vegetative States, Transient

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