Lawrence M
University of Hartford, West Hartford, Conn, USA.
Am J Crit Care. 1995 May;4(3):227-32.
Although considerable research has been done on pathophysiology, metabolic and physical causes, and prognostic indicators, little is known about unconsciousness or coma from the perspective of the patient.
To describe the experiences of patients who were once documented as being unconscious.
Phenomenologic interviews were conducted with 100 patients whose records indicated that they had been unconscious during hospitalization. Interviews were also attempted with primary family members, significant others, or other external observers. Chart audits documenting the unconscious episode, medications, and diagnoses were also carried out. Data were compared, using van Kaam's method, and contrasted.
Patients experienced one or more of five states: unconsciousness, inner consciousness, perceived unconsciousness, distorted consciousness, and paranormal experiences. They described hearing, understanding, and responding emotionally to what was being said when it was assumed they were not aware. In addition, 23 subjects reported near-death experiences or visits, out-of-body experiences, or some other paranormal experience.
Patients' unconscious experiences can cause long-term effects. Patients often need reassurance that other patients subjected to similar conditions also have these experiences.
尽管在病理生理学、代谢和物理原因以及预后指标方面已经进行了大量研究,但从患者的角度来看,对昏迷或无意识状态却知之甚少。
描述曾被记录为昏迷的患者的经历。
对100名住院期间有昏迷记录的患者进行了现象学访谈。还尝试对其主要家庭成员、重要他人或其他外部观察者进行访谈。同时对记录昏迷事件、用药情况和诊断的病历进行了审核。使用范·卡姆方法对数据进行比较和对比。
患者经历了以下五种状态中的一种或多种:无意识、内心意识、感知到的无意识、意识扭曲和超自然体验。他们描述了在被认为没有意识的时候,能够听到、理解并对所说的话产生情感反应。此外,23名受试者报告了濒死体验或濒死探访、体外体验或其他一些超自然体验。
患者的无意识体验可能会产生长期影响。患者通常需要得到保证,即经历类似情况的其他患者也有这些体验。