Measurement of impaired self-awareness after traumatic brain injury: a comparison of the patient competency rating scale and the awareness questionnaire

PRIMARY OBJECTIVE: To compare the Patient Competency Rating Scale (PCRS) and the Awareness Questionnaire (AQ) in the measurement of impaired self-awareness (ISA) in persons with traumatic brain injury (TBI). RESEARCH DESIGN: Prospective cohort of patients seen for inpatient rehabilitation following TBI. PROCEDURES: Measures of self-awareness were collected at resolution of post-traumatic amnesia and outcomes (rated employability) were collected at discharge from inpatient rehabilitation. OUTCOMES AND RESULTS: Subjects were 129 persons with TBI. Measures from the PCRS and AQ showed moderate correlations. Models using as predictors patient/clinician discrepancies for the PCRS and the AQ performed comparably in predicting employability (Nagelkerke R(2) = 0.22 and 0.20, respectively). CONCLUSIONS: The PCRS and AQ showed only moderate correlations, but performed comparably as measures of ISA after TBI. Patient/clinician discrepancies appeared to be more valid measures of ISA early after TBI than patient/family discrepancies. Preliminary cutting points for severity of ISA were presented for the two scales.