Impaired self-awareness after acquired brain injury: clinicians' ratings on its assessment and importance for rehabilitation

BACKGROUND:: Impaired self-awareness is a potential obstacle to successful rehabilitation. OBJECTIVE:: To obtain clinicians' ratings of the importance of self-awareness for brain injury rehabilitation and use of instruments to assess self-awareness. PARTICIPANTS:: One hundred sixty-three members of 3 major Dutch organizations for neuropsychology or rehabilitation. MAIN MEASURE:: Online survey addressing: (1) factors participants consider important for the course and success of rehabilitation, (2) whether they assess patients' levels of self-awareness, and (3) the instruments they use to do so. RESULTS:: Of the 163 respondents, 116 (71.2%) considered self-awareness to be important for the course of rehabilitation; 113 (69.3%) considered it to be important for the success of rehabilitation. One hundred fifty-six clinicians (95.7%) reported assessing patients' levels of self-awareness, but only 12 (7.4%) reported using standardized instruments specifically designed for this purpose. The instruments most frequently reported to be used were the Awareness Questionnaire and Patient Competency Rating Scale. CONCLUSIONS:: It is difficult to capture different aspects of self-awareness in a standardized manner. There is a need for instruments that are valid and reliable and that have good clinical utility.