title: The efficacy of prospective memory rehabilitation plus metacognitive skills training for adults with traumatic brain injury: study protocol for a randomized controlled trial.
abstract: Impairment of prospective memory (PM) is common following traumatic brain injury (TBI) and negatively impacts on independent living. Compensatory approaches to PM rehabilitation have been found to minimize the impact of PM impairment in adults with TBI; however, poor self-awareness after TBI poses a major barrier to the generalization of compensatory strategies in daily life. Metacognitive skills training (MST) is a cognitive rehabilitation approach that aims to facilitate the development of self-awareness in adults with TBI. This paper describes the protocol of a study that aims to evaluate the efficacy of a MST approach to compensatory PM rehabilitation for improving everyday PM performance and psychosocial outcomes after TBI.
  
  
  
  This randomized controlled trial has three treatment groups: compensatory training plus metacognitive skills training (COMP-MST), compensatory training only (COMP), and waitlist control. Participants in the COMP-MST and COMP groups will complete a 6-week intervention consisting of six 2-h weekly training sessions. Each 1.5-h session will involve compensatory strategy training and 0.5 h will incorporate either MST (COMP-MST group) or filler activity as an active control (COMP group). Participants in the waitlist group receive care as usual for 6 weeks, followed by the COMP-MST intervention. Based on the sample size estimate, 90 participants with moderate to severe TBI will be randomized into the three groups using a stratified sampling approach. The primary outcomes include measures of PM performance in everyday life and level of psychosocial reintegration. Secondary outcomes include measures of PM function on psychometric testing, strategy use, self-awareness, and level of support needs following TBI. Blinded assessments will be conducted pre and post intervention, and at 3-month and 6-month follow-ups.
  
  
  
  This study seeks to determine the efficacy of COMP-MST for improving and maintaining everyday PM performance and level of psychosocial integration in adults with moderate to severe TBI. The findings will advance theoretical understanding of the role of self-awareness in compensatory PM rehabilitation and skills generalization. COMP-MST has the potential to reduce the cost of rehabilitation and lifestyle support following TBI because the intervention could enhance generalization success and lifelong application of PM compensatory strategies.
  
  
  
  New Zealand Clinical Trials Registry, ACTRN12615000996561 . Registered on 23 September 2015; retrospectively registered 2 months after commencement.
authors.affiliation: School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, 4072, QLD, Australia. j.fleming@uq.edu.au.|Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia. j.fleming@uq.edu.au.
authors.forename: Jennifer
authors.identifier: 0000-0002-5603-2410
authors.initials: J
authors.lastname: Fleming
authors.affiliation: Menzies Health Institute Queensland and School of Applied Psychology, Griffith Health Institute, Griffith University, Mount Gravatt, QLD, Australia.
authors.forename: Tamara
authors.initials: T
authors.lastname: Ownsworth
authors.affiliation: School of Health and Rehabilitation Sciences, University of Queensland, Brisbane, 4072, QLD, Australia.
authors.forename: Emmah
authors.initials: E
authors.lastname: Doig
authors.affiliation: Menzies Health Institute Queensland and School of Applied Psychology, Griffith Health Institute, Griffith University, Mount Gravatt, QLD, Australia.
authors.forename: Lauren
authors.initials: L
authors.lastname: Hutton
authors.affiliation: Occupational Therapy Department, Princess Alexandra Hospital, Brisbane, Australia.
authors.forename: Janelle
authors.initials: J
authors.lastname: Griffin
authors.affiliation: Acquired Brain Injury Outreach Service, Princess Alexandra Hospital, Metro South Hospital and Health Service, Woolloongabba, QLD, Australia.|Menzies Health Institute Queensland and School of Human Services and Social Work, Griffith University, Meadowbrook, QLD, Australia.
authors.forename: Melissa
authors.initials: M
authors.lastname: Kendall
authors.affiliation: Menzies Health Institute Queensland and School of Applied Psychology, Griffith Health Institute, Griffith University, Mount Gravatt, QLD, Australia. d.shum@griffith.edu.au.
authors.forename: David H K
authors.initials: DH
authors.lastname: Shum
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D000368:Aged; D001364:Awareness; D001921:Brain / Q000503:physiopathology*; D000070642:Brain Injuries, Traumatic / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D002985:Clinical Protocols; D015928:Cognitive Behavioral Therapy / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D008569:Memory Disorders / Q000175:diagnosis / Q000503:physiopathology / Q000523:psychology / Q000534:rehabilitation*; D061212:Memory, Episodic; D000067489:Metacognition; D008875:Middle Aged; D011594:Psychometrics; D011788:Quality of Life; D011793:Queensland; D020127:Recovery of Function; D012107:Research Design; D012720:Severity of Illness Index; D011795:Surveys and Questionnaires; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
keywords: Brain injury; Prospective memory; Randomized controlled trial; Rehabilitation; Self-awareness