Concordance between the Awareness Questionnaire and Self-Awareness of Deficits Interview for identifying impaired self-awareness in individuals with traumatic brain injury in the community
Tamara Ownsworth, Jennifer Fleming, Emmah Doig, David H.K. Shum, Sarah Swan
Objective: To investigate concordance between the Awareness Questionnaire (AQ) and Self-Awareness of Deficits Interview (SADI) for identifying impaired self-awareness in the community after traumatic brain injury.
Design: A retrospective file audit was conducted to retrieve data on the AQ and SADI for participants with traumatic brain injury involved in previous studies on community-based outcomes. Concordance between the AQ and SADI was examined using receiver operating characteristic curves for different scores on each measure.
Participants: A total of 80 individuals with moderate-to-severe traumatic brain injury (81% male, mean age = 32.25 years, standard deviation (SD) = 11.5 years) living in the community.
Methods: Participants were administered the AQ and SADI and their significant other completed the AQ and SADI checklist.
Results: Consistency of classification of impaired self-awareness between the AQ and SADI was high (i.e. 80–84%) based on scores reflecting good sensitivity and specificity. Corresponding scores on the 2 measures and rates of impaired self-awareness were as follows: SADI > 3~AQ discrepancy > 4 (45–48% with impaired self-awareness); SADI > 4~AQ discrepancy > 9 (26–34% with impaired self-awareness); SADI > 5~AQ discrepancy >12 (13–26% with impaired self-awareness).
Conclusion: The AQ and SADI yielded consistent information regarding the presence of impaired self-awareness in community-based individuals with traumatic brain injury. The choice of measure may depend on how the tool is being used to guide rehabilitation planning.
People often do not recognize changes in their abilities or skills after traumatic brain injury. Such problems with self-awareness can lower people’s motivation to take part in rehabilitation. Two common approaches used to assess self-awareness include a brief questionnaire (e.g. 5 min) and a longer interview process (e.g. 20 min). This study aimed to identify the consistency in information and opinions formed about self-awareness from these 2 approaches. The Awareness Questionnaire and Self-Awareness of Deficits Interview were administered to 80 people with traumatic brain injury. Their family members also provided information about the abilities of the person with brain injury. Overall, there was good consistency in information gained about self-awareness between these measures. These findings suggest that similar information can be gained from a questionnaire or interview; however, the choice of measure may depend on how the tool is being used to guide rehabilitation planning.
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