Abstract
Purpose This study aims to explore the difference in cognitive strategy use during observed occupational performance between and within different levels of impaired awareness of deficits of individuals with acquired brain injury (ABI). Design/methodology/approach A cross-sectional study (N = 24) of individuals with ABI receiving rehabilitation and with the capacity to demonstrate goal-directed behaviour (Allen cognitive level screen score = 4.0) was undertaken. Cognitive strategy use during occupational performance of daily activities (measured with the perceive, recall, plan and perform [PRPP]) was evaluated between and within different awareness levels (awareness levels measured by the self-regulation skill interview). Statistical analyses, using independent t-test, Mann Whitney U test, ANOVA and Friedman test, were executed. Findings Significant differences were shown for both strengths and weaknesses in cognitive strategy use between emergent (n = 13) and anticipatory awareness (n = 11) groups on PRPP items “perceive”, “sensing” and “mapping”; and “searches”, “recall steps”, “identify obstacles”, “calibrates”, “stops”, “continues” and “persists”. Within emergent awareness group, participants scored lowest related to “perceive”, “plan”, “sensing”, “mapping”, “programming” and “evaluating”. Within anticipatory awareness group, participants scored lowest related to “plan”, “programming” and “evaluating”. Practical implications This study showed differences in cognitive strategy application during task performance in individuals with emergent or anticipatory awareness deficits that fit with theoretical expectations. It is recommended to make use of the PRPP assessment results (strengths and weaknesses in cognitive strategy application) to support the level of awareness determination. The PRPP assessment results and the level of awareness tailor the clinical reasoning process for personalised intervention planning and cognitive strategy training. Originality/value Because impaired awareness has so much impact on the course and outcome of rehabilitation (Rotenberg-Shpigelman et al., 2014), in clinical practice, it is of paramount importance to be aware of the level of awareness of the client (Smeets et al., 2017) and the effect on occupational performance.
Highlights
Acquired brain injury (ABI) is one of the major causes of disability and death worldwide
This study showed differences in cognitive strategy application during task performance in individuals with emergent or anticipatory awareness deficits that fit with theoretical expectations
The prevalence of individuals with impaired awareness of deficits ranges from 45%– 97% depending on the type and severity of the injury and time since injury (Hartman-Maeir et al, 2003; Freeland, 1996; Sherer et al, 1998)
Summary
Acquired brain injury (ABI) is one of the major causes of disability and death worldwide. Noting impaired awareness of deficits is one of the cognitive deficits after ABI (Bach and David, 2006). The prevalence of individuals with impaired awareness of deficits ranges from 45%– 97% depending on the type and severity of the injury and time since injury (Hartman-Maeir et al, 2003; Freeland, 1996; Sherer et al, 1998). This is an important group of clients seen within rehabilitation; it is important to address awareness of deficits in rehabilitation
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