Abstract
Purpose: To quantify traumatic brain injury (TBI) patients’ perceptions of own function by the Patient Competency Rating Scale (PCRS) one year after injury, and to examine self-awareness of functional deficits by comparing PCRS ratings from patients (PCRS-P) and PCRS ratings from near relatives (PCRS-R), and to identify predictors of awareness deficits. Method: A cohort of 50 severe (n = 33) and moderate (n = 17) TBI patients. Awareness of deficits was investigated by subtracting PCRS relative ratings from PCRS patient ratings. Predictors of PCRS ratings and differences were assessed by stepwise multiple regression analyses.Results: The average patient PCRS sum score was 122/150 (95% CI = 115; 129) as compared to a sum score of 117/150 (95% CI = 110; 125), given by their relatives (p = 0.93). The patients scored themselves slightly higher than their relatives in the domains of activities of daily living (ADL) and cognitive function (p < 0.001, p < 0.001). Regression analyses showed that Glasgow Coma Scale (GCS)score at admission to rehabilitation was the strongest predictor of patient PCRS (B = 3.314, p = 0.008). The strongest predictor of differences between patient and relative PCRS was GCS acute (B= −3.530, p = 0.001).Conclusions: TBI patients demonstrated a slight “awareness gap” in ADL and cognitive function. Low GCS in the acute phase and high age were the strongest predictors of self- awareness deficits.
Traumatic brain injury (TBI) may result in various cognitive, motor, sensory, social and emotional deficits. How TBI patients perceive their own functional level is less described.
Lack of awareness is associated with poorer functional outcome, higher caregiver distress and poor compliance with rehabilitation.
TBI patients demonstrated a slight “awareness gap” in ADL and cognitive function.
Low Glasgow Coma Scale score in the acute phase and high age were the strongest predictors of self-awareness deficits.
Acknowledgements
We would like to thank statistician Are Hugo Pripp at Oslo University Hospital, for his supervision in statistics. Thanks to ward leader Lars-Otto Nome and physiatrist Rein Knoph and their team colleagues at Department of Rehabilitation, Sørlandet Hospital, Kristiansand, for co-operation and data collection.
Declaration of Interest: This study has been financed with the aid of extra funds from the Norwegian Foundation for Health and Rehabilitation. No previous presentation of the research, manuscript or abstract exists.