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Assessing emergence from a prolonged disorder of consciousness: Current opinion and practice in the UK

Pundole, A; Varley, R; Beeke, S; (2020) Assessing emergence from a prolonged disorder of consciousness: Current opinion and practice in the UK. Neuropsychological Rehabilitation 10.1080/09602011.2020.1758160. (In press).

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Abstract

BACKGROUND: A patient in PDOC must demonstrate functional object use or functional communication to confirm they have emerged from this state. A range of tasks and stimuli are used and patients must achieve 100% accuracy. As consciousness occurs along a continuum, determining emergence is not straightforward. OBJECTIVE: To establish the opinions of expert clinicians on how emergence is determined in practice. METHODS: An online survey was completed by clinicians working in specialist rehabilitation settings across the UK. Questions were asked about diagnosis and confidence, informal assessment, formal assessment, and family involvement. Descriptive statistics were used to analyse responses to closed questions. Responses to open questions were analysed using thematic analysis. RESULTS: Seventy-five surveys were analysed. Approximately a third (30.4 %) used tasks other than those recommended to determine emergence. A lack of confidence in tasks to detect the return of functional communication was reported by 46.4%. The majority (78.6%) reported they worked with patients who they felt had emerged, but could not demonstrate it based on the current criteria. A range of stimuli were employed, but 30.6% of respondents were not confident they could choose stimuli appropriately. Respondents reported a range of benefits and challenges when involving family in assessment.

Type: Article
Title: Assessing emergence from a prolonged disorder of consciousness: Current opinion and practice in the UK
Location: England
DOI: 10.1080/09602011.2020.1758160
Publisher version: https://doi.org/10.1080/09602011.2020.1758160
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: Assessment, Emergence, Family, Prolonged disorder of consciousness (PDOC), Severe cognitive impairment
UCL classification: UCL
UCL > Provost and Vice Provost Offices
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Brain Sciences > Div of Psychology and Lang Sciences > Language and Cognition
URI: https://discovery.ucl.ac.uk/id/eprint/10097449
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