Nonverbal communication of trauma patients in a state of minimal consciousness

Abstract

Introduction In spite of the rapid development in various communication-support technologies for those waking up from a coma, studies describing the sole process of reconstructing communication in this group of patients are scarce. Objective The aim of this study was to analyze communication reactions in a minimal state of consciousness and describe the nonverbal behaviours characteristic for each stages significant for the therapy of communication. Material and methods 18 severely brain-injured patients in a minimal state of consciousness participated in the half-year observation study, which included people experiencing at least 4 weeks of consciousness disorder/coma. Age of patients 25±5 years. Psychological assessment included: observation of various attempts of communications undertaken by patients, caregivers and family interview, the Glasgow Coma Scale (GCS) and Individual Communication Sheet. Results Data analysis showed a significant increase in preverbal communication, both in primal and sensory areas when compared between Stage II (GCS=6–8 points) and Stage III (GCS=9–12 points). After a time, primary communication reached a high level. Patients produced communication attempts from the behaviour organization level, and an increase in the nonverbal communication level was noted. Based on observations, nonverbal communication profiles for each stage of waking up from a coma were introduced. Conclusions It was found that in the process of waking up from a coma the patients communicate with the use of the preverbal level of primal communication, the sensory and behaviour organization activities. The characteristics of the communication reactions show that in Stage III there is a significant increase in two preverbal communication areas: primal and sensory acts, when compared with Stage II.

Keywords

• Traumatic brain injury
• consciousness
• coma
• microgenetic theory
• body language