Postcomatose unawareness/vegetative state following severe brain injury: a content methodology

Postcomatose unawareness/vegetative state (PCU/VS) is an altered state of consciousness that may follow coma. It is characterized by wakefulness without awareness of self or the environment. While most frequently associated with trauma, it is also associated with anoxia, vascular injury or encephalitis. In this article, the clinical phenomenon of PCU/VS is explored using the content methodology process (CMP) in order to explicate content for nursing practice. There are five steps in the process: literature review, identification of the characteristic features and patient behaviors associated with PCU/VS, description of the specific abilities that are affected, formulation of nursing assessment and intervention approaches, and evaluation of these approaches in clinical practice and research. In this article, there is an extensive review and analysis of the literature related to PCU/VS. Substantive nursing knowledge was developed using the CMP. It was determined that the Freeman Questionnaire and the Sensory Stimulation Assessment Measure are appropriate tools to assess the interpretative abilities of patients with PCU/VS during the acute care period. Sensory regulation techniques that are appropriate for use during patient care to promote the recovery of cognitive abilities were identified. Both the recommended tools and the intervention approaches require further validation in empirical research.