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Psychological needs of patients in low awareness states, their families, and health professionals

7 important questions on Psychological needs of patients in low awareness states, their families, and health professionals

What is special about psychological caring for pt. who have emerged from low awareness state or vegetive state?

Assumed patients in VS cannot possess self-awareness necessary for experiencing psychological distress. These patients have limited communicative skills but still possible to adapt psychological intervention. Few patients can benefit from above (do not have communicative skills) but can benefit from behavioral techniques

Name 3 causes of families experience of emotions such as shock, guilt, anxiety, denial, depression, hostility when pt. is in low awareness state

1. loss of person

2. changes of roles

3. complex medical ethical decisions

What makes a low awareness state difficult to cope with for family members?

1. When there is little expectation of recovery, loss family comparable with bereavement. Relatives unable to mourn and adjust loss given body still alive.

2. patient receives intense and expensive care which indicates that there is still hope

3. There is even hope in absence of improvement, news papers may contribute to this

What is a reason family members of pt. in low awareness state often feel guilty?

thinking the pt. would rather be dead than in VS but do not want to lose hope

Name sources that can difficult the relationship between relatives of pt. in low awareness state and his clinician

1. Disagreement between relatives and clinician due to misunderstanding diagnosis of low awareness state by relatives.

2. Relatives find it hard to appreciate diagnosis when pt. exhibit non-purposeful movements or noises.

3. When relatives wish to continue treatment because of their wish of recovery when the treatment will not benefit pt.

4. Clinicians reporting good progress pt. But Goal of clinician is not recovery where goal of relatives is recovery.

5. Hostility and complaints of relatives as emotional reactions to problems with adjusting

6. Lack of clarity by professionals when explaining diagnosis

Name 2 interventions suggested for family of pt. in low awareness state

1. Encourage families to seek psychological support. interventions such as CBT effective for depression, guilt and bereavement

2. Plan interventions containing education, involvement rehabilitation and decision-making, family support groups and group therapy

Name 4 psychological problems of clinicians working with people in low awareness state might experience

1. Difficulty clinician when issue arises of withdrawal of nutrition and hydration when working with pt. for a while

2. Individual differences clinicians based on religion an culture

3. Difficulties of junior health care staff without formal training or caring for dying pt.

4. Source of job satisfaction because one can see little improvement in pt and are not showing gratitude towards staff.

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Advanced CN Family affair week 6

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Psychological needs of patients in low awareness states, their families, and health professionals

7 important questions on Psychological needs of patients in low awareness states, their families, and health professionals

What is special about psychological caring for pt. who have emerged from low awareness state or vegetive state?

Name 3 causes of families experience of emotions such as shock, guilt, anxiety, denial, depression, hostility when pt. is in low awareness state

What makes a low awareness state difficult to cope with for family members?

What is a reason family members of pt. in low awareness state often feel guilty?

Name sources that can difficult the relationship between relatives of pt. in low awareness state and his clinician

Name 2 interventions suggested for family of pt. in low awareness state

Name 4 psychological problems of clinicians working with people in low awareness state might experience

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