Patients in a permanent vegetative state or minimally conscious state in the Maine-et-Loire county of France: A cross-sectional, descriptive study.
OBJECTIVE
To determine how many patients in a permanent vegetative state or a minimally conscious state are living in healthcare institutions in the Maine-et-Loire county of western France. To evaluate patient management, physical complications, problems encountered by nursing staff and the patient care teams' wishes.


METHODS
We performed a cross-sectional, descriptive study in physical medicine and rehabilitation departments, nursing homes, geriatric units and local hospitals. All patients and their medical records were examined by the same investigator. A questionnaire for carers was used to evaluate nursing tasks and a second questionnaire for head nurses served to assess staff needs and the patient care teams' wishes.


RESULTS
Thirteen patients were identified. Four were in a permanent vegetative state and nine were in a minimally conscious state. Ten patients were cared for in geriatric units, one in a physical medicine and rehabilitation department and two in local hospitals. All patients displayed limited joint angle ranges. All the patient care teams reported practical difficulties and ethical issues.


CONCLUSIONS
Our survey highlighted the variety of care scenarios for patients in a permanent vegetative state or a minimally conscious state. It revealed practical difficulties and, above all, ethical questions. The present work could serve as a basis for implementation of a recently issued French government circular on defining specific wards for these patients.
Saoût
V
V
CRRRF-CHU d'Angers, France. vsaout8@gmail.com
Ombredane
M-P
MP
Mouillie
J-M
JM
Marteau
C
C
Mathé
J-F
JF
Richard
I
I
D000328:Adult; D016223:Advance Directives; D000368:Aged; D017028:Caregivers; D019090:Case Management / Q000941:ethics / Q000458:organization & administration / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004750:Enteral Nutrition; D005260:Female; D005602:France / Q000453:epidemiology; D006301:Health Services Needs and Demand; D006299:Health Services for the Aged / Q000706:statistics & numerical data; D006757:Hospital Units / Q000706:statistics & numerical data; D006801:Humans; D008134:Long-Term Care / Q000941:ethics / Q000379:methods / Q000706:statistics & numerical data; D008297:Male; D008875:Middle Aged; D009128:Muscle Spasticity / Q000209:etiology / Q000534:rehabilitation; D009745:Nursing, Supervisory; D010347:Patient Care Planning; D010348:Patient Care Team; D018458:Persistent Vegetative State / Q000453:epidemiology* / Q000451:nursing / Q000534:rehabilitation / Q000628:therapy; D012720:Severity of Illness Index; D012866:Skilled Nursing Facilities / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires; D014139:Tracheostomy