The Self-Awareness Multilevel Assessment Scale, a New Tool for the Assessment of Self-Awareness After Severe Acquired Brain Injury: Preliminary Findings

Abstract

Self-awareness (SA) is frequently impaired after severe acquired brain injury (sABI) and may lead to reduced subject’s compliance to treatment, worse functional outcome, and high caregiver distress. Considering the multifaceted nature of SA, a specific and effective assessment is crucial to address treatment of impairment of SA (ISA). Many tools can currently assess ISA; however, they have some important limits. In the present study, we proposed the Self-Awareness Multilevel Assessment Scale (SAMAS), a new scale for assessment of SA at different levels (i.e., declarative , emergent , and anticipatory ) across all domains of functioning. The SAMAS has been designed to be administered by the cognitive/behavioral therapist with the involvement of a patient’s relative. Findings showed that the SAMAS allowed specifically assessing SA at a declarative level and on all possible functional domains. More interestingly, it seems also able to assess both emergent and anticipatory SA, thus overcoming some important limits of other current assessment methods. Our findings are consistent with a holistic perspective of the patient with sABI because thanks to the combined use of assessing tools, the SAMAS can provide an accurate diagnosis of ISA, thus better addressing the neurorehabilitation treatment and, accordingly, reducing the possible occurrence of its primary and secondary implications.

Willingness to age in place and anosognosia of risks in Alzheimer’s disease

“…De plus, l'anosognosie même complique l'identification des risques par le professionnel, du fait de l'absence de consensus concernant sa définition, son évaluation et son évolution temporelle [29]. Actuellement, plusieurs échelles cliniques existent pour mesurer l'anosognosie, notamment la Self-Awareness Multilevel Assessment Scale (SAMAS) mesurant la conscience de soi à différents niveaux (déclaratif, émergent et anticipatif), avec la représentation du proche aidant [65] ; ou encore, l'échelle clinique Patient Competency Rating scale-neu-rorehabilitationImpaired self-awareness (PCRS-NR), récemment développée, qui mesure l'anosodiaphorie chez des patients ayant une lésion cérébrale grave [66]. Pour autant, même si les gériatres identifient adéquatement l'importance de l'anosognosie dans l'évaluation de l'aptitude au maintien à domicile, ils se réfèrent rarement aux échelles structurées du fait de l'hétérogénéité de celles-ci [67].…”

Clinician reports of self-awareness after traumatic brain injury: a retrospective chart review

“…There were limited reports of self-awareness assessment use with clinicians reporting on clients' levels of self-awareness, task-specific challenges, and interventions for self-awareness. Research has shown that self-awareness assessments are important in order to assess and evaluate different components of a client’s self-awareness [ 38 ]. Additionally, components such as anticipatory awareness needs to be objectively assessed by a clinician [ 38 ].…”

“…Research has shown that self-awareness assessments are important in order to assess and evaluate different components of a client’s self-awareness [ 38 ]. Additionally, components such as anticipatory awareness needs to be objectively assessed by a clinician [ 38 ]. In our study, less than 10% of clients were reported as receiving a self-awareness assessment.…”