Zhongguo quanke yixue (Sep 2023)
Advances in Rehabilitation Outcomes and Care in Patients with Prolonged Disorders of Consciousness
Abstract
Prolonged disorders of consciousness (pDoC) severely affects the patients' survival and quality of life, and causes an extremely heavy disease burden. At present, considerable resources and studies have focused on the acute care of patients with pDoC, and substantial progress has been made in detecting, predicting and promoting recovery of consciousness, but there is little research on post-acute rehabilitation outcomes and care. In views of this, we reviewed the definition, epidemiological surveys, clinical symptoms and diagnosis criteria of pDoC, summarized the associated factors, interventions and nursing regarding rehabilitation outcomes of pDoC. Then, we put forward the following recommendations relevant to future research and practice in China: (1) improving the epidemiological data related to pDoC to provide data for relevant decision-making; (2) studying and applying new technologies to interventions for pDoC rehabilitation, and integrating clinical practice, rehabilitation prediction and prognostic management; (3) further identifying key elements and trajectory for pDoC recovery to reduce the uncertainty of prognostic outcomes due to excessive disease duration; (4) establish a continuity of care system based on the pDoC rehabilitation trajectory from acute transition, sub-acute to chronic period to improve the quality of and access to care and achieve continuous improvement in the quality of care; (5) systematically reforming the current care system to further improve the continuity of care system that contributes to rehabilitation, and strengthening the participation of the patient's family, community, disability agencies and other stakeholders besides the multidisciplinary team and the cooperation between them. It is hoped that we can provide insights into the development of research and clinical practice of pDoC in China.
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