Self-awareness in Adults with Traumatic Brain Injury: Exploring the Profile of Intellectual Awareness in Rehabilitation

Research Objectives To investigate the profile of self-awareness for patients with traumatic brain injury and to make recommendations for practice in rehabilitation. Design Non-interventional cohort study with clinical audit of self-awareness interview applying thematic analysis. Setting A large public acquired brain injury rehabilitation unit in Australia. Participants A convenience sample of adults aged 18-70 years with TBI (n=106) admitted to inpatient rehabilitation who received self-awareness assessment. Interventions Not applicable. Main Outcome Measures Self-awareness of deficits interview (SADI). Results Total SADI scores ranged from 0-9, with 72% of participants scoring 4 or above indicating moderate to severe impairment of self-awareness. Awareness of deficits: Seventeen impairment areas were identified, with impaired physical function most frequently cited (83%), along with memory impairment (46%) and other cognitive impairment (40%). Functional implications of deficits: Nineteen functional areas were identified, with driving (49%) and work (39%) most frequently cited, and 36% of participants reporting no TBI-related problems; 24% of participants stated the need for further exposure to activities to understand functional implications. Ability to identify realistic goals: Thirty-two goal areas were identified, with work most frequently cited (54%) and skills improvement (41%). Fifty-three percent of participants in the 7-9 SADI score category (i.e., severe impairment) stated that their TBI would not have an impact in 6 months' time, while 43% of the participants in the ≤1 SADI score category (i.e., no impairment) reported that TBI would have an ongoing impact. Conclusions A clinical interview such as the SADI provides an opportunity to understand the patient's perspective of their abilities, impairments and goals, and provides a comprehensive profile of self-awareness to inform treatment planning. Author(s) Disclosures Jennifer Fleming is also the author of the SADI.