Living in limbo: the low-level brain-injured patient and the patient's family.
One hallmark of severe traumatic brain injury (TBI) is a loss of consciousness followed by varying states of consciousness. Estimates suggest that 30-40% of individuals who survive severe TBI will stay in low-level or reduced states of consciousness for prolonged periods. The state of coma is relatively easy to diagnose; however, differential diagnosis of other states of reduced consciousness have proven to be much more difficult, precipitating a number of problems related to prognosis, treatment, and rehabilitation. Accurate diagnosis is critical in determining the prognosis for persons with severe TBI because it has significant implications for the patient, family, clinician, and payer. Studies have shown that prognosis directly influences numbers and types of treatments recommended. Often, families find themselves being forced to make critical decisions with little knowledge and a great deal of uncertainty. Understanding reduced states of consciousness and facilitating accurate evaluation of such states allow neuroscience nurses to help families effectively cope during this difficult time.
Hauber
R P
RP
TeleRehabilitation Program, Shepherd Center, Atlanta, GA 30309, USA.
Testani-Dufour
L
L
D001930:Brain Injuries / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D017028:Caregivers / Q000523:psychology*; D003244:Consciousness Disorders / Q000175:diagnosis / Q000523:psychology* / Q000534:rehabilitation; D006801:Humans; D009730:Nursing Assessment; D011368:Professional-Family Relations; D011379:Prognosis