The Effects of Familiar Voices on the Level of Consciousness among Comatose Patients: A Single-Blind Randomized Controlled Trial

Abstract

Background: Brain injury can reduce consciousness and the ability to respond to environmental stimulation.
 Objectives: The aim of this study was to investigate the effects of familiar voices on the level of consciousness (LOC) among comatose patients with a brain injury hospitalized in the intensive care unit.
 Methods: In this randomized controlled trial, sixty comatose patients with head trauma were conveniently selected from an intensive care unit of a hospital in Rasht, Iran, and randomly allocated to either a control or an intervention group. Participants in the intervention group received auditory stimulation for three consecutive days and the level of consciousness was compared in two groups. The Glasgow Coma Scale was used to assess the patients’ level of consciousness. The data were analyzed through the Chi-square, the paired-samples t, student’s t test, and the repeated-measures analysis of variance. 
 Results: A significant increase was found in the mean LOC in the intervention group after every daily auditory stimulation (P<0.05). However, no significant changes were observed in the control group (P>0.05). The repeated-measures analysis of variance revealed that the time and interaction of time and groups were statistically significant (P<0.001).
 Conclusion: Auditory stimulation with familiar voice was effective in improving levels of consciousness among comatose patients with a brain injury after three days.

Outcomes of family‐centred auditory and tactile stimulation implementation on traumatic brain injured patients

“…The reasons for that can be due to the different number of days, the nature of the voice played, and the duration of the intervention. In this respect, Mohammadi and Yeganeh ( 2019 ) also reported that their study of the effects of familiar voices on the level of consciousness among comatose patients indicated no statistically significant differences in hemodynamic parameters including blood pressure, body temperature, respiratory rate, heart rate and SPO 2 between the intervention and the control groups of patients. This could be attributed to the type of auditory stimulus and different sounds that can have different effects on patient.…”

“…Sensory deprivation can slow the recovery of central nervous function (Cheng et al, 2018 ). Considering the need for organized sensory stimulation in comatose TBI patients, it is much more effective if provided by a family member since this can change the patient's sensory stimulation to a meaningful content and promote patient's peace and comfort through making a supporting and familiar environment, and consequently hasten the improvement of patients' level of consciousness and disease prediction (Mohammadi & Yeganeh, 2019 ). Hence, the current study was implemented to assess the effects of Family‐centred organized Auditory and Tactile stimulation on critically ill patients following TBI level of consciousness and Physiological Adverse Events.…”

“…This scale was adopted from Teasdale and Jennett ( 1974 ) to assess the patient's level of consciousness. Tool reliability had been approved in previous studies (Mohammadi & Yeganeh, 2019 ). The scale is based on numerical value assigned to the assessment of three responses namely, eye opening response, verbal response, and motor response.…”

Interventions Facilitating Recovery of Consciousness Following Traumatic Brain Injury: A Systematic Review

“…Of the 480 studies screened for eligibility, 27 met inclusion criteria for this study (Figure 1). Of these, 22 were randomized control trials (Bahonar et al, 2019; Cavinato et al, 2019; Chuaykarn & Jitpanya, 2017; Frazzitta et al, 2016; He et al, 2018; Hediger et al, 2019; Hoseinzadeh et al, 2017; Kalani et al, 2016; Krewer et al, 2015; Martens et al, 2019; Martens et al, 2018; Megha et al, 2013; Moattari et al, 2016; Mohammadi et al, 2019; Pape et al, 2015; Park & Davis, 2016; Parveen et al, 2015; Rahimi et al, 2019; Salmani et al, 2017; Thibaut et al, 2014, 2017; Werner et al, 2016), one was a non-randomized control trial (Lei et al, 2015), one was a prospective observational study (Bartolo et al, 2017), one was a ABAB withdrawal design (Cheng et al, 2018), and two studies used a one group pre-post design (Riberholt et al, 2013; Sato et al, 2017). Studies were thematically grouped by intervention: sensory stimulation ( n = 14), non-invasive brain stimulation ( n = 7), mobility ( n = 4), animal-assisted intervention ( n = 1), and non-invasive nerve stimulation ( n = 1) (Table 1).…”

“…Familiar voices telling structured, familiar stories. One Level 1B study with low risk of bias (Mohammadi et al, 2019), one Level 1B study with moderate risk of bias (Parveen et al, 2015), and one Level 2B study with low risk of bias (Pape et al, 2015) provide moderate strength of evidence for familiar voices telling structured, familiar stories (Tables 1 and 2A). The emotionally relevant story that was 8 to 10 min in length was either delivered either by a family member at the bedside (Parveen et al, 2015) or via a recording (Mohammadi et al, 2019;Pape et al, 2015).…”