期刊名称：Annals of Agricultural and Environmental Medicine
印刷版ISSN：1232-1966
电子版ISSN：1898-2263
出版年度：2019
卷号：26
期号：2
页码：1-5
DOI：10.26444/aaem/91911
出版社：Institute of Agricultural Medicine in Lublin
摘要：Introduction. In spite of the rapid development in various communication-support technologies for those waking up from
a coma, studies describing the sole process of reconstructing communication in this group of patients are scarce.
Objective. The aim of this study was to analyze communication reactions in a minimal state of consciousness and describe
the nonverbal behaviours characteristic for each stages significant for the therapy of communication.
Materials and method. 18 severely brain-injured patients in a minimal state of consciousness participated in the half-year
observation study, which included people experiencing at least 4 weeks of consciousness disorder/coma. Age of patients
25±5 years. Psychological assessment included: observation of various attempts of communications undertaken by patients,
caregivers and family interview, the Glasgow Coma Scale (GCS) and Individual Communication Sheet.
Results. Data analysis showed a significant increase in preverbal communication, both in primal and sensory areas when
compared between Stage II (GCS=6–8 points) and Stage III (GCS=9–12 points). After a time, primary communication reached
a high level. Patients produced communication attempts from the behaviour organization level, and an increase in the
nonverbal communication level was noted. Based on observations, nonverbal communication profiles for each stage of
waking up from a coma were introduced.
Conclusions. It was found that in the process of waking up from a coma the patients communicate with the use of the
preverbal level of primal communication, the sensory and behaviour organization activities. The characteristics of the
communication reactions show that in Stage III there is a significant increase in two preverbal communication areas: primal
and sensory acts, when compared with Stage II.
关键词：traumatic brain injury; awareness; coma; microgenetic theory; body language
