Motivational Interviewing to promote self-awareness and engagement in rehabilitation following acquired brain injury: A conceptual review

Abstract Objective Impaired self-awareness (SA) is a common symptom after suffering acquired brain injury (ABI) which interferes with patient’s rehabilitation and their functional independence. SA is associated with executive function and declarative memory, two cognitive functions that are related to participants’ daily living functionality. Through this observational study, we aim to explore whether SA may play a moderator role in the relation between these two cognitive processes and functional independence. Method A sample of 69 participants with ABI completed a neuropsychological assessment focused on executive function and declarative memory which also included a measure of SA and functional independence. Two separated linear models were performed including functional independence, SA, and two neuropsychological factors (declarative memory and executive function) derived from a previous principal component analysis. Results Moderation analysis show a significant interaction between SA and executive function, reflecting an association between lower executive functioning and poorer functional outcome, only in participants with low levels of SA. Notwithstanding, declarative memory do not show a significant interaction with SA, even though higher declarative memory scores were associated with better functional independence. Conclusions SA seems to play a moderator effect between executive function, but not declarative memory, and functional independence. Accordingly, participants with executive deficits and low levels of SA might benefit from receiving specific SA interventions in the first instance, which would in turn positively impact on their functional independence.

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A-103 Examining Self-Awareness in Acute Stroke and Traumatic Brain Injury Populations

Archives of Clinical Neuropsychology ◽

10.1093/arclin/acab062.121 ◽

2021 ◽

Vol 36 (6) ◽

pp. 1152-1152

Author(s):

Vanessa Watorek ◽

Susan Shwartz ◽

Chelsea Day

Keyword(s):

Traumatic Brain Injury ◽

Brain Injury ◽

Acute Stroke ◽

Left Hemisphere ◽

Acquired Brain Injury ◽

Self Awareness ◽

Review Of The Literature ◽

Level Of Education ◽

Patient Awareness ◽

The Difference

Abstract Objective Following acquired brain injury (ABI), self-awareness of deficits is frequently diminished. A review of the literature suggests most investigations of self-awareness following ABI have been in traumatic brain injury (TBI) populations, with emerging research in those with stroke (e.g., Al Banna et al., 2016). Therefore, this study examined self-awareness across diagnoses, neuroanatomical correlates, and demographics. Method Participants included 82 patients (TBI n = 59 and stroke n = 23) from an inpatient ABI unit. Patients, neuropsychologists, and family members completed the Awareness Questionnaire (AQ). The difference between patient-clinician or patient-family total score was examined, with scores >20 suggestive of impaired self-awareness. Results Participants with left-hemisphere (LH) injury endorsed higher functioning (Patient Total) compared to those with right or bilateral injury, p 0.05. However, there was greater difference scores between those with TBI compared to stroke on patient-clinician total cognitive scores t(80) = 2.125, p = 0.037 and patient-family behavioral/affective total scores t(15.86) = 4.045, p < 0.001 such that those with TBI’s were more aware of their deficits. Regarding demographics, level of education predicted level of patient awareness, but no demographic factors predicted the overall difference score. Conclusions Individuals with LH injury may be more prone to reduced awareness than expected. Additionally, specific domains of functioning may be more useful in examining awareness deficits across diagnostic groups than overall scores.

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