Patients' recollections of their posttraumatic coma.
Patients' recollections of posttraumatic coma as viewed retrospectively were explored in this descriptive study. Fifteen patients from two urban north Texas hospitals who incurred traumatic head injury and associated coma (Glasgow Coma Scale score of 8 or less for at least six hours) were interviewed. A set of open-ended questions was developed and utilized in a semi-structured interview with each subject. Data such as age, sex, type of injury, how injury occurred, Glasgow Coma Scale score, and duration of coma were collected. Responses elicited during the interviews were analyzed qualitatively. In this investigation seven subjects reported no recollections of being comatose. Eight were able to relate experiences with three prevailing themes: imprisonment, sensory experiences, and death-like experiences. Four subjects recalled actions perceived as helpful and not helpful while in coma. Recollections of unconsciousness appeared to have been affected by the length of coma but not by the Glasgow Coma Scale score or the type of head injury sustained. These findings reveal patients in coma from a traumatic head injury have a limited degree of awareness of the environment. That awareness should be incorporated into nursing management of the comatose patient in acute and chronic care settings.
Tosch
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Parkland Memorial Hospital, Dallas, TX 75235.
D000293:Adolescent; D000328:Adult; D001293:Attitude to Death; D001930:Brain Injuries / Q000523:psychology*; D003128:Coma / Q000523:psychology*; D005260:Female; D006801:Humans; D008297:Male; D008568:Memory; D011939:Mental Recall; D008875:Middle Aged; D010268:Parapsychology; D014474:Unconsciousness / Q000523:psychology