Conceptualization of Self-awareness After Acquired Brain Injury: A Qualitative Systematic Review

Abstract

<h3>Objective(s)</h3> To establish (1) the theoretical models and frameworks of self-awareness in adults with acquired brain injury; and (2) how self-awareness is conceptualized within those models. <h3>Data Sources</h3> Medline, CINAHL, EMBASE, PsycINFO, and Cochrane databases were searched, references were screened and expert recommendations were included. Search parameters included English-language papers published up until December 2020. <h3>Study Selection</h3> Two independent reviewers screened titles and abstracts for all identified papers, and removed duplicates. Full text review by two reviewers determined a final set of papers for inclusion that met the following criteria: literature that articulates an original comprehensive definition and/or theoretical model or conceptual framework related to self-awareness in adults with acquired brain injury. From 7913 references, 35 were included in the review. <h3>Data Extraction</h3> Two reviewers extracted textual data that included study characteristics, definitions of self-awareness, description of model/framework, application to clinical practice, and author recommendations for assessment and/or intervention. Quality assessment was completed by two authors using a 6-item critical appraisal tool. <h3>Data Synthesis</h3> Narrative synthesis methodology was used to organize, comprehensively assess and synthesize the findings. Within these, 13 models, 12 conceptual frameworks and 2 theories were described. The main themes and subthemes were: Clinical presentation of self-awareness (classifications and dimensions of self-awareness), development of self-awareness (knowledge, feedback mechanisms, temporal aspects, self-evaluation, enablers, barriers), understanding (dys)function (cognitive processing mechanisms, neurological foundations, causal factors), and practice guidance (assessment and intervention). <h3>Conclusions</h3> There is a broad range of information to promote understanding of self-awareness for adults with ABI which provides a foundation to support future research to support development of targeted assessment and treatment approaches. <h3>Author(s) Disclosures</h3> There are no conflicts to declare.