Impaired self-awareness is a common problem following traumatic brain injury. Without adequate self-awareness, a person's motivation to participate in rehabilitation may be limited, which in turn can have an adverse effect on his or her functional outcome. For this reason, it is important that brain injury rehabilitation professionals, including occupational therapists, both understand this phenomenon and use assessment and treatment approaches aimed at improving clients' self-awareness.This article provides an overview of self-aw areness, reviewing the distinction between intellectual and online awareness. The current role of occupational therapy in the assessment of self-awareness is highlighted and the guidelines for new assessments of self-awareness suitable for use in occupational therapy are explored. Downloaded from Physical Medicine and Rehabilitation, 82, 49-55. Allen CC, Ruff RM (1990) Self-rating versus neuropsychological performance of moderate versus severe head-injured patients. Brain Injury, 4(1), 7-17. American Occupational Therapy Association (1997) Fundamental concepts of occupational therapy: occupation, purposeful activity, and function. American Journal of Occupational Therapy, 51, 864-66. Anderson SW, Tranel D (1989) Awareness of disease states following cerebral infarction, dementia, and head trauma: standardised assessment. Clinical Neuropsychologist, 3(4), 327-39. Barco PP, Crosson B, Bolesta MM, Werts D, Stout R (1991) Training awareness and compensation in postacute head injury rehabilitation. In: JS Kreutzer, PH Wehman, eds. Cognitive rehabilitation for persons with traumatic brain injury: a functional approach. Baltimore, MD: Paul H Brookes, 129-46. Ben Yishay Y, Diller L (1981) Rehabilitation of cognitive and perceptual deficits in people with traumatic brain damage. International Journal of Rehabilitation Medicine, 4, 208-10. Ben-Yishay Y, Diller L (1993) Cognitive remediation in traumatic brain injury: update and issues. Archives of Physical Medicine and Rehabilitation, 74, 204-13. Bergquist TF, Jacket MP (1993) Programme methodology: awareness and goal setting with the traumatically brain injured. Brain Injury, 7(3), 275-82. Bisiach E, Vallar G, Perani D, Papagno C, Berti A (1986) Unawareness of disease following lesions of right hemisphere: anosognosia for hemiplegia and anosognosia for hemianopia. Neuropsychologia, 24, 471-82. Brooks DN, McKinlay WW (1983) Personality and behavioural change after severe blunt head injury -a relative's view. Journal of Neurology, Neurosurgery and Psychiatry, 46, 336-44. Bruininks R, Woodcock RW, Weatherman RF, Hill BK (1984) Scales of independent behaviour, interviewer's manual. Allen, TX: DLM Teaching Resources. Crosson B, Barco PP, Velozo CA, Bolesta MM, Cooper PV, Werts D, Brobeck TC (1989) Awareness and compensation in postacute head injury rehabilitation. Journal of Head Trauma Rehabilitation, 4, 46-54. Deaton AV (1986) Denial in the aftermath of traumatic head injury: its manifestations, measurement and treatment. Rehabilitation Psychology...
High test-re-test reliability was demonstrated for both total (ICC = 0.94) and sub-section scores (ICC = 0.85, 0.86 and 0.86). The results, combined with previous research indicating the high inter-rater reliability of the SADI, suggest the SADI is a reliable means of evaluating level of self-awareness. Further research is required to investigate other psychometric properties of the SADI and the two checklists.
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