Seeing minds in patients with disorders of consciousness

ABSTRACT

Objective: To explore the ways in which health care professionals and families understand terms and concepts associated with disorders of consciousness.

Methods: Open-ended, semi-structured interviews were conducted with 20 health care professionals and 18 family caregivers affiliated with a disorders of consciousness program within a nationally ranked rehabilitation facility in the United States.

Results: Analysis revealed that: (1) disagreement between some health care professionals and family caregivers regarding the presence of consciousness can arise due to differing beliefs about a patient experiencing pain, and differences in the length of time family caregivers spend with patients relative to clinical staff; (2) some health care professionals and family caregivers use nonclinical terms and concepts to describe consciousness; and (3) some family caregivers might attribute complex mental capacities to patients, which extend beyond the clinical evidence.

Conclusion: The beliefs of health care professionals and families regarding disorders of consciousness are complex and could be influenced by broader psychological proclivities to “see minds” in patients who have a liminal neurological status. Awareness of these dynamics may assist health care professionals when interacting with family caregivers.

KEYWORDS:

• Minimally conscious state
• vegetative state
• caregiver
• psychology
• rehabilitation
• cognitive

Disclosure

The authors have no conflicts of interest to disclose.

Supplementary material

Supplemental data for this article can be accessed publisher’s website.

Additional information

Funding

This work was supported by the Greenwall Foundation [Greenwall Faculty Scholars program]; TIRR Memorial Hermann [BCM2015-01].