title: Online awareness of functional tasks following ABI: the effect of task experience and associations with underlying mechanisms.
abstract: BACKGROUND
  Self-awareness is a significant predictor of neurorehabilitation process and outcome and encompasses metacognitive knowledge and online awareness. The literature focuses primarily on intellectual awareness and research on online awareness is lacking.
  
  
  OBJECTIVE
  To examine online awareness for functional tasks, how it is affected by task experience and its relationships with neurogenic and psychogenic factors.
  
  
  METHODS
  Thirty six adults with ABI attending neurorehabilitation participated in this study. Online awareness was measured as the discrepancy between subjective ratings of performance and performance on functional tasks, as rated by experienced therapists. Participants' ratings were recorded before and immediately after task experience, as well as following a mediated review of task steps. The Impaired Self-Awareness scale (ISA) and the Denial of Disability scale (DD) rated neurogenic and psychogenic mechanisms of unawareness.
  
  
  RESULTS
  Results indicated significant differences between therapists' and participants' ratings before and after IADL task performance, and following mediation. Participants typically overestimated their functional independence and did not significantly change their ratings after task experience. Significant moderate to strong correlations were found between online awareness measures and both DD and ISA scales.
  
  
  CONCLUSIONS
  Overestimation of functional independence is common in persons with ABI, is related to both neurogenic and psychogenic factors and is not significantly affected by single task experience. Further studies are required to examine the effect of theoretically driven awareness interventions in neurorehabilitation.
authors.affiliation: School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem, Jerusalem, Israel.
authors.forename: Shlomit
authors.initials: S
authors.lastname: Rotenberg-Shpigelman
authors.affiliation: Reuth Center for Rehabilitation Medicine and Chronic Care, Tel Aviv, Israel.
authors.forename: Lee
authors.initials: L
authors.lastname: Rosen-Shilo
authors.affiliation: School of Occupational Therapy, Faculty of Medicine, Hadassah and the Hebrew University of Jerusalem, Jerusalem, Israel.
authors.forename: Adina
authors.initials: A
authors.lastname: Maeir
mesh_terms: D000203:Activities of Daily Living / Q000523:psychology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001364:Awareness; D001930:Brain Injuries / Q000175:diagnosis* / Q000523:psychology / Q000534:rehabilitation*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009788:Occupational Therapy / Q000379:methods*; D011597:Psychomotor Performance; D055815:Young Adult
keywords: ABI; Online awareness; neurorehabilitation; task performance