Research Reports - Development of self-awareness after severe traumatic brain injury through participation in occupation-based rehabilitation

Am J Occup Ther. 2014 Sep-Oct;68(5):578-88

Doig E(1), Kuipers P(2), Prescott S(3), Cornwell P(4), Fleming J(5)

OBJECTIVE. We examined participation in goal planning and development of
self-awareness for people with impaired self-awareness after traumatic brain
injury. METHOD. We performed a mixed-methods study of 8 participants recently
discharged from inpatient rehabilitation. Self-awareness was measured using
discrepancy between self and significant other ratings on the Mayo-Portland
Adaptability Index (MPAI-4) at four time points. We calculated effect size to
evaluate the change in MPAI-4 discrepancy over time. RESULTS. Seven participants
identified their own goals. We found a large reduction in mean MPAI-4 discrepancy
(M = 8.57, SD = 6.59, N = 7, d = 1.08) in the first 6 wk and a further small
reduction (M = 5.33, SD = 9.09, N = 6, d = 0.45) in the second 6 wk of
intervention. Case data indicated that 7 participants demonstrated some growth in
self-awareness. CONCLUSION. Engagement in occupation-based, goal-directed
rehabilitation appeared to foster awareness of injury-related changes to varying

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