Components of self-awareness affecting caregiver burden: a long-term follow-up study

ABSTRACT

Objective

Studies utilizing the discrepancy model of the Mayo-Portland Adaptability Inventory-4 (MPAI-4) have commonly used the cognitive and physical domains to estimate self-awareness. This study included other aspects of self-awareness such as awareness of one’s social and emotional status and daily functioning to explore their effects on caregiver burden for ABI survivors.

Methods

We studied 64 patient-caregiver pairs up to 29 years post-discharge from a holistic, milieu-oriented outpatient neurorehabilitation program. Discrepancy scores between ABI survivors’ and caregivers’ reports on the MPAI-4 subscales (i.e. Abilities, Adjustment, and Participation) and Total Score were used to determine self-awareness. Caregiver burden was measured using the Zarit Burden Interview (ZBI).

Results

Exploratory linear regression analyses revealed that caregiver burden derived from the ZBI was predicted by the discrepancy scores generated from the Abilities (p < 0.0001), Adjustment (p < 0.01), Participation subscales (p = 0.01), and Total Score (p < 0.001), respectively. Among the exploratory models generated, the Total Score model had the highest predictive value (R2 = .33) for caregiver burden.

Conclusions

Measures of self-awareness should be comprehensive by considering diverse components of self-awareness. Increasing ABI survivors’ self-awareness in different domains has the potential to effectively alleviate caregiver burden.

KEYWORDS:

• Anosognosia
• impaired self-awareness
• brain injuries
• neurological rehabilitation
• caregiver burden

Acknowledgments

A special thank you to Edward Koberstein for his thoughtfulness and proficiency in technical and editing support.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by the Barrow Neurological Foundation.