SAFE Scale for Caregivers of Patients with Disorders of Consciousness
Author Information
Author(s): Francesca Giulia Magnani, Martina Cacciatore, Filippo Barbadoro, Camilla Ippoliti, Davide Sattin, Alfonso Magliacano, Francesca Draghi, Bahia Hakiki, Francesca Cecchi, Marcella Spinola, Agnese De Nisco, Anna Estraneo, Matilde Leonardi
Primary Institution: Fondazione IRCCS Istituto Neurologico Carlo Besta, Milan, Italy
Hypothesis
Can the SAFE scale improve the assessment of consciousness levels in patients with Disorders of Consciousness when used by caregivers?
Conclusion
The SAFE scale shows promise for helping caregivers assess the level of consciousness in patients with Disorders of Consciousness, especially in challenging monitoring environments.
Supporting Evidence
- The SAFE scale demonstrated very high internal consistency (α = 0.912).
- The SAFE showed high criterion validity when correlated to the CRS-r total score (Spearman’s rho = 0.708).
- The SAFE allowed detection of higher-level consciousness behaviors in over half of the sample compared to CRS-r.
- Caregivers spent an average of 8.48 hours per week caring for patients.
- Patients had a median time since injury of 20.31 months.
- SAFE total scores were significantly higher in patients with at least minimal signs of consciousness.
- Discrepancies between SAFE and CRS-r evaluations were noted, suggesting caregivers may detect behaviors missed by clinicians.
- SAFE can be used in telemedicine and long-term care settings.
Takeaway
The SAFE scale helps caregivers share their observations about patients who can't communicate, making it easier for doctors to understand how the patients are doing.
Methodology
Caregivers filled in the SAFE scale while patients were assessed using the Coma Recovery Scale-revised (CRS-r).
Potential Biases
Potential overestimation of patients' consciousness levels by caregivers due to emotional involvement.
Limitations
The small sample size limits the generalizability of the results.
Participant Demographics
Median age of caregivers: 61 years; 15 females; Median age of patients: 54 years; 14 males.
Statistical Information
P-Value
0.001
Statistical Significance
p<0.001
Digital Object Identifier (DOI)
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