title: Evaluation of nursing interventions using minimally invasive assessments methods for patients in a persistent vegetative state.
abstract: OBJECTIVE
  This study aimed to evaluate the effects of nursing interventions using minimally invasive or non-invasive methods conducive to frequent use in order to assess patients in a persistent vegetative state (PVS).
  
  
  METHODS
  We provided three nursing interventions-sitting the patient in an upright position, footbath care, and oral care-to PVS patients (n = 11) and elderly bedridden subjects with consciousness (n = 6) for 3 weeks in addition to ordinary nursing treatments. The Kohnan Score, plasma cortisol and adrenaline levels, General Well-Being Schedule score, and facial expression assessments were used as evaluation methods.
  
  
  RESULTS
  The Kohnan Score of PVS patients declined significantly, indicating that the interventions increased patients' consciousness levels, but none of the other parameters showed significant change in either group. The change in Kohnan Score showed dependent trends for facial expression at baseline, cortisol change during the intervention, and the term of PVS.
  
  
  CONCLUSIONS
  The data suggest three indices for predicting intervention efficacy in individuals and for assessing an intervention's contribution to quality of life improvement. Among the multiple evaluation methods, Konan Scores was the most effective. Ultimately, the three nursing interventions used in this study and Konan Score led to the optimization of nursing home care and rehabilitation for PVS patients.
authors.affiliation: Department of Human Arts and Sciences, Graduate School of the University of Human Arts and Sciences, Saitama, Japan.|Nursing Science, Human Care Department, Tohto College of Health Sciences, Fukaya, Japan.|Division of Salivary Gland and Health Medicine, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan.
authors.forename: Mitsue
authors.initials: M
authors.lastname: Sato
authors.affiliation: Division of Salivary Gland and Health Medicine, Department of Oral Science, Graduate School of Dentistry, Kanagawa Dental University, Yokosuka, Japan.|Institute for Advanced Biosciences, Keio University, Tsuruoka, Japan.
authors.forename: Masahiro
authors.initials: M
authors.lastname: Sugimoto
authors.affiliation: Shonan Hospital, Yokosuka, Japan.
authors.forename: Kazuo
authors.initials: K
authors.lastname: Yamaguchi
authors.affiliation: Department of Human Arts and Sciences, Graduate School of the University of Human Arts and Sciences, Saitama, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Kawaguchi
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D003243:Consciousness / Q000502:physiology*; D005149:Facial Expression; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009732:Nursing Care / Q000379:methods*; D010043:Outcome and Process Assessment, Health Care; D018458:Persistent Vegetative State / Q000175:diagnosis / Q000451:nursing*; D011788:Quality of Life
keywords: footbath care; nursing; oral health; persistent vegetative state; sitting in an upright position