Longitudinal changes in functioning and disability in patients with disorders of consciousness: The importance of environmental factors

M. Willems, D. Sattin, A.J.J.M. Vingerhoets, M. Leonardi

Research output: Contribution to journalArticleScientificpeer-review

40 Downloads (Pure)

Abstract

Disorders of consciousness are neurological conditions associated with low levels of functioning which pose a serious challenge to public health systems. The current study aimed to examine longitudinal changes in functioning in patients with disorders of consciousness and to identify associated biopsychosocial factors using the International Classification of Functioning, Disability, and Health. An Italian sample of 248 patients was assessed longitudinally. Differences in relative variability (an index of change that controls for baseline levels) between acute and chronic patients and predictors of relative variability in “Activities & Participation” were examined. Results showed that there were subgroups of patients whose functioning improved over time. The number of problems in “Activities & Participation” decreased in acute patients over time, whereas in chronic patients, an increase was found. The significant difference in relative variability for the environmental factor “support and relationships” reflects the increase in facilitators in acute patients, whereas the number of facilitators in chronic patients remained unchanged over time. Age at event, time from event, and relative variability in “Environmental Factors” were significant predictors of relative variability in “Activities & Participation”. It is of clinical relevance that patients with disorders of consciousness are kept in a supportive and facilitative environment, in order to prevent a decline in their functioning. Moreover, caregivers should receive tailored support in order to enhance and facilitate appropriate care of patients with disorders of consciousness. View Full-Text Keywords: unresponsive wakefulness syndrome; vegetative state; minimally conscious state; disorders of consciousness; disability; functioning; International Classification of Functioning; Disability; and Health; longitudinal study
Original languageEnglish
Pages (from-to)3707-3730
JournalInternational Journal of Environmental Research and Public Health
Volume12
Issue number4
DOIs
Publication statusPublished - 2015

Fingerprint

Persistent Vegetative State
Wakefulness
Nervous System Diseases
Caregivers

Cite this

@article{da262896c37041a8a91d3408737e8a63,
title = "Longitudinal changes in functioning and disability in patients with disorders of consciousness: The importance of environmental factors",
abstract = "Disorders of consciousness are neurological conditions associated with low levels of functioning which pose a serious challenge to public health systems. The current study aimed to examine longitudinal changes in functioning in patients with disorders of consciousness and to identify associated biopsychosocial factors using the International Classification of Functioning, Disability, and Health. An Italian sample of 248 patients was assessed longitudinally. Differences in relative variability (an index of change that controls for baseline levels) between acute and chronic patients and predictors of relative variability in “Activities & Participation” were examined. Results showed that there were subgroups of patients whose functioning improved over time. The number of problems in “Activities & Participation” decreased in acute patients over time, whereas in chronic patients, an increase was found. The significant difference in relative variability for the environmental factor “support and relationships” reflects the increase in facilitators in acute patients, whereas the number of facilitators in chronic patients remained unchanged over time. Age at event, time from event, and relative variability in “Environmental Factors” were significant predictors of relative variability in “Activities & Participation”. It is of clinical relevance that patients with disorders of consciousness are kept in a supportive and facilitative environment, in order to prevent a decline in their functioning. Moreover, caregivers should receive tailored support in order to enhance and facilitate appropriate care of patients with disorders of consciousness. View Full-Text Keywords: unresponsive wakefulness syndrome; vegetative state; minimally conscious state; disorders of consciousness; disability; functioning; International Classification of Functioning; Disability; and Health; longitudinal study",
author = "M. Willems and D. Sattin and A.J.J.M. Vingerhoets and M. Leonardi",
year = "2015",
doi = "10.3390/ijerph120403707",
language = "English",
volume = "12",
pages = "3707--3730",
journal = "International Journal of Environmental Research and Public Health",
issn = "1661-7827",
publisher = "MDPI AG",
number = "4",

}

Longitudinal changes in functioning and disability in patients with disorders of consciousness : The importance of environmental factors. / Willems, M.; Sattin, D.; Vingerhoets, A.J.J.M.; Leonardi, M.

In: International Journal of Environmental Research and Public Health, Vol. 12, No. 4, 2015, p. 3707-3730.

Research output: Contribution to journalArticleScientificpeer-review

TY - JOUR

T1 - Longitudinal changes in functioning and disability in patients with disorders of consciousness

T2 - The importance of environmental factors

AU - Willems, M.

AU - Sattin, D.

AU - Vingerhoets, A.J.J.M.

AU - Leonardi, M.

PY - 2015

Y1 - 2015

N2 - Disorders of consciousness are neurological conditions associated with low levels of functioning which pose a serious challenge to public health systems. The current study aimed to examine longitudinal changes in functioning in patients with disorders of consciousness and to identify associated biopsychosocial factors using the International Classification of Functioning, Disability, and Health. An Italian sample of 248 patients was assessed longitudinally. Differences in relative variability (an index of change that controls for baseline levels) between acute and chronic patients and predictors of relative variability in “Activities & Participation” were examined. Results showed that there were subgroups of patients whose functioning improved over time. The number of problems in “Activities & Participation” decreased in acute patients over time, whereas in chronic patients, an increase was found. The significant difference in relative variability for the environmental factor “support and relationships” reflects the increase in facilitators in acute patients, whereas the number of facilitators in chronic patients remained unchanged over time. Age at event, time from event, and relative variability in “Environmental Factors” were significant predictors of relative variability in “Activities & Participation”. It is of clinical relevance that patients with disorders of consciousness are kept in a supportive and facilitative environment, in order to prevent a decline in their functioning. Moreover, caregivers should receive tailored support in order to enhance and facilitate appropriate care of patients with disorders of consciousness. View Full-Text Keywords: unresponsive wakefulness syndrome; vegetative state; minimally conscious state; disorders of consciousness; disability; functioning; International Classification of Functioning; Disability; and Health; longitudinal study

AB - Disorders of consciousness are neurological conditions associated with low levels of functioning which pose a serious challenge to public health systems. The current study aimed to examine longitudinal changes in functioning in patients with disorders of consciousness and to identify associated biopsychosocial factors using the International Classification of Functioning, Disability, and Health. An Italian sample of 248 patients was assessed longitudinally. Differences in relative variability (an index of change that controls for baseline levels) between acute and chronic patients and predictors of relative variability in “Activities & Participation” were examined. Results showed that there were subgroups of patients whose functioning improved over time. The number of problems in “Activities & Participation” decreased in acute patients over time, whereas in chronic patients, an increase was found. The significant difference in relative variability for the environmental factor “support and relationships” reflects the increase in facilitators in acute patients, whereas the number of facilitators in chronic patients remained unchanged over time. Age at event, time from event, and relative variability in “Environmental Factors” were significant predictors of relative variability in “Activities & Participation”. It is of clinical relevance that patients with disorders of consciousness are kept in a supportive and facilitative environment, in order to prevent a decline in their functioning. Moreover, caregivers should receive tailored support in order to enhance and facilitate appropriate care of patients with disorders of consciousness. View Full-Text Keywords: unresponsive wakefulness syndrome; vegetative state; minimally conscious state; disorders of consciousness; disability; functioning; International Classification of Functioning; Disability; and Health; longitudinal study

U2 - 10.3390/ijerph120403707

DO - 10.3390/ijerph120403707

M3 - Article

VL - 12

SP - 3707

EP - 3730

JO - International Journal of Environmental Research and Public Health

JF - International Journal of Environmental Research and Public Health

SN - 1661-7827

IS - 4

ER -