Disorders of Consciousness Clinical Trial
Official title:
Families Expectations and Hope Raised by an Evaluation of Consciousness in Patients With an Unresponsive Wakefulness Syndrome
Progress in resuscitation has increased the chances of survival after anoxic or traumatic
brain injury. More and more patients with severe cerebral damages are resuscitated but upon
awakening from coma, some patients remain in a state which cannot be qualified as conscious
and is now known as an unresponsive wakefulness syndrome (UWS; formerly known as vegetative
state). This condition can be transitory and evolve towards recovery, or remain chronic and
lasting for years.
To improve the diagnosis of patients with disorders of consciousness, recent advances in
brain imaging have led to the development of new methods of detecting awareness. In the
absence of overt behavioral responses from these patients, imaging-based diagnostic methods
have been first used to assess whether some cerebral areas were preserved in UWS patients
and showed an activation of the primary sensory cortices in some UWS patients, whether it
occurs at the auditory, visual or somatosensory level. Unavoidable technical and ethical
issues are raised for clinicians before responding to such requests:
1. Is it technically possible to generalize neuroimaging protocols to all healthcare
institutions?
2. Is it ethically acceptable to propose neuroimaging protocols without an accurate
estimation of their psychological impact on families and caregivers?
The present study aims to understand and anticipate the technical and ethical issues related
to an evaluation of consciousness with functional neuroimaging. How the evaluation of
awareness in a patient affects the caregivers and family members will be investigated. By
using qualitative research hopes and expectations will be clarified through the experiences
of families, clinicians and nurses faced to this situation.
Will be included in this research professional caregivers and persons closely related to UWS
patients:
- Family members or close circle visiting the patients on a regular basis
- Referring clinicians
- Nurses in charge of the patients' care
This prospective study uses qualitative, interview-based, research. Two key-moments are
explored in succession to examine the impact of a neuroimaging evaluation of consciousness
in institutionalized UWS patients:
- interviews of professional caregivers and families about their hopes concerning the
evaluation of consciousness of UWS patients,
- interviews of professional caregivers and families about the impact of evaluating
consciousness on their beliefs
n/a
Intervention Model: Single Group Assignment, Masking: Open Label
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