BACKGROUND: Although considerable research has been done on pathophysiology, metabolic and physical causes, and prognostic indicators, little is known about unconsciousness or coma from the perspective of the patient. OBJECTIVE: To describe the experiences of patients who were once documented as being unconscious. METHODS: Phenomenologic interviews were conducted with 100 patients whose records indicated that they had been unconscious during hospitalization. Interviews were also attempted with primary family members, significant others, or other external observers. Chart audits documenting the unconscious episode, medications, and diagnoses were also carried out. Data were compared, using van Kaam's method, and contrasted. RESULTS: Patients experienced one or more of five states: unconsciousness, inner consciousness, perceived unconsciousness, distorted consciousness, and paranormal experiences. They described hearing, understanding, and responding emotionally to what was being said when it was assumed they were not aware. In addition, 23 subjects reported near-death experiences or visits, out-of-body experiences, or some other paranormal experience. CONCLUSION: Patients' unconscious experiences can cause long-term effects. Patients often need reassurance that other patients subjected to similar conditions also have these experiences.

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