Levels of self-awareness after acute brain injury: how patients' and rehabilitation specialists' perceptions compare.
OBJECTIVE
To examine self-awareness regarding performance on 4 daily living tasks and to test theoretical predictions for a model of self-awareness in persons with acquired brain injury.


METHODS
A comparative design examining the level of self-awareness recorded by patients and actual patient performance as judged by rehabilitation clinicians.


METHODS
A community-based residential center providing comprehensive rehabilitation services to persons with acquired brain injury.


METHODS
Fifty-five persons with acquired brain injury and the identified potential to return to independent function in the community. Ten subjects without brain injury provided comparison data.


METHODS
Information was collected by using patient self-report, clinician rating of patient performance, patient rating of non-brain-injured subjects, and clinician rating of non-brain-injured subjects.


METHODS
Three self-awareness criteria were examined: intellectual, emergent, and anticipatory. Self-awareness was rated for 3 tasks: dressing, meal planning, and money management.


RESULTS
Statistically significant differences (p <.05) were found for all levels of self-awareness across the 3 tasks. Persons with brain injury judged their abilities higher than clinician ratings of actual performance. No statistical support was found for a hierarchy among intellectual, emergent, and anticipatory self-awareness.


CONCLUSIONS
No evidence was found supporting a hierarchy among levels of self-awareness as defined and measured in the present study. New methods for operationally defining intellectual, emergent, and anticipatory self-awareness are necessary to examine the relationship between self-awareness and performance.
Transitional Learning Center, Galveston, University of Texas Medical Branch at Galveston, USA.
B C
BC
Abreu
G
G
Seale
R S
RS
Scheibel
N
N
Huddleston
L
L
Zhang
K J
KJ
Ottenbacher
D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D001364:Awareness / Q000502:physiology*; D001930:Brain Injuries / Q000503:physiopathology / Q000523:psychology* / Q000534:rehabilitation; D016009:Chi-Square Distribution; D004185:Disability Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D018709:Statistics, Nonparametric