Self-awareness after acquired brain injury--predictors and rehabilitation.
OBJECTIVE
To investigate the factors contributing to deficit in self-awareness following acquired brain injury and to study change in self-awareness during a group support program.


METHODS
Sixty-two patients (mean age: 35.4 +/- 15.3 years) attending our Service (295 +/- 525 days after injury) were included in the study (41 of them had sustained a head injury). Thirty-six patients were admitted to a multidisciplinary rehabilitation program including a group support program designed to improve self-awareness deficits. All patients were assessed with the Patient Competency Rating Scale as a measure of self-awareness and with a broad range of neuropsychological tests, checklists of psychopathological symptoms, and several functional scales.


RESULTS
Thirty patients showed high levels of self-awareness while 32 showed impaired self-awareness. Patients with appropriate perception of their deficits showed less psychopathological symptoms, better neuropsychological function and higher functional independence than those with impaired SA (Student's t test, p < 0.05). Both groups improved, but with different patterns, after rehabilitation (MANOVA, p < 0.05). Multiple regression analysis revealed that cognitive status was predictive of level of self-awareness.


CONCLUSIONS
The level of self-awareness after acquired brain injury is a useful prognostic index of the neuropsychological, psychopathological and functional status of the patient. We recommend the evaluation of this symptom after acquired brain injury due to its clinical relevance.
Noé
E
E
Servicio de Daño Cerebral, Hospital Valencia al Mar, C/Río Tajo n1, 46011, Valencia, Spain. enoe@comv.es
Ferri
J
J
Caballero
M C
MC
Villodre
R
R
Sanchez
A
A
Chirivella
J
J
D000203:Activities of Daily Living; D000328:Adult; D001930:Brain Injuries / Q000150:complications / Q000523:psychology / Q000534:rehabilitation; D003072:Cognition Disorders / Q000209:etiology / Q000523:psychology / Q000534:rehabilitation; D003430:Cross-Sectional Studies; D004185:Disability Evaluation; D005260:Female; D015600:Glasgow Coma Scale / Q000706:statistics & numerical data; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009483:Neuropsychological Tests / Q000706:statistics & numerical data; D011569:Psychiatric Status Rating Scales / Q000706:statistics & numerical data; D012044:Regression Analysis; D012189:Retrospective Studies; D012647:Self-Assessment; D013997:Time Factors; D016896:Treatment Outcome
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