Article

PURPOSES: 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. PATIENTS AND 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. DISCUSSION: 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.
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Langue : ANGLAIS ; FRANCAIS