Loewenstein communication scale for the minimally responsive patient

Abstract

The LCS for the minimally responsive patients proved to be reliable and predictive of rehabilitation progress of minimally responsive patients. It may be useful for the interdisciplinary rehabilitation team in planning early individually targeted therapeutic programmes.

Use of the quasi-experimental sequential cohort design in the Study of Patient–Nurse Effectiveness with Assisted Communication Strategies (SPEACS)

“…90. The LCS also demonstrated good predictive ability in distinguishing between brain injured patients in a vegetative state and those who had rehabilitation potential [46].…”

“…Ratings are recorded by the data collector during interview with family members or significant others during study enrollment. [46]. The LCS measures 5 behavioral functions (Mobility, Respiration, Visual Responsiveness, Auditory Comprehension, and Linguistic Skills) by rating 5 items per category on a 5-point scale.…”

Guidelines for Quality Management of Apallic Syndrome / Vegetative State

“…Regarding the reported high level of AS/VS misdiagnosis [127][128][129] we would like to suggest a practical education in AS management for at least three years like in other sub-specialities. This should qualify the doctor too to furnish the expert opinion concerning the right diagnose of a (permanent) AS full stage and early remission stages [6,14,54,67,69,72,[132][133][134][135]. Detailed assessment is important if the reported high level of misdiagnosis is to be avoided [127,[67][68][69].…”

“…As a result of modern emergency and intensive care medical treatment and diagnostic neuroimaging, many patients who would have died in the past increasingly survive acute traumatic and nontraumatic brain damage and chronic progressive neurological diseases, however, at the expense of full AS, remission defect or end stage, respectively. For Europe prevalence of AS in hospital cases is reported to be 0.5-2/100.000 population/year, about one quarter to one-third secondary to acute traumatic and roughly 70% following acute nontraumatic brain damage and chronic neurological diseases [2,5,18,26,28,29,37,54,59,60]. Over the past two decades, especially designed institutions for early neurological-neurosurgical rehabilitation (ENNR) of apallic patients after severe brain damage and nursing homes for permanent attention stimulating care of completely disabled patients have been established in Europe, thanks to national medical-social health authorities, public and private care providers, and care givers on a legal provision insurance basis [2,14,15,27,28,[60][61][62][63][64][65].…”

“…There is no single specific laboratory investigation, no specific medical treatment, no specific rehabilitative regimen or stimulating intervention that can be recommended on evidence class II (or III) level to improve higher cerebral mental cognitive functioning and independent social outcome [2,15,23,28,30,49,51,65,66]. The purpose of this contribution is to recommend quality management for patients suffering from full stage and emerging from AS of different functional stages as a consequence of posttraumatic and non-traumatic brain damage, needing an even better early assessment and ongoing monitoring of impaired functioning [2,6,22,26,27,34,37,54,60,[67][68][69][70][71][72]. Neurorehabilitation aimes at social reintegration or adequate humane nursing care [6,14].…”