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The insight interview: a new tool for measuring deficits in awareness after traumatic brain injury
Tania Malouf1, Robyn Langdon, Alan Taylor
1Queensland Paediatric Rehabilitation Service, Royal Children's Hospital , Brisbane , Australia .
Objective:
Awareness deficits are common after traumatic brain injury (TBI); however, relatively little is known of awareness deficits in the early stages post-injury. This study outlines the development of a new tool, 'The Insight Interview', designed to measure awareness across different domains (awareness of change, severity of deficits, current and future functional consequences) from 3 months post-TBI.
Methods:
Forty-three patients with at least a severe TBI, their nominated family member and treating clinician were all administered different versions of the Insight Interview during the patient's inpatient stay. Awareness was measured; (1) by calculating a discrepancy score between the patient's and their family informant's and/or clinician's ratings of the patient's abilities and (2) using interviewer-based ratings of the patients' responses to interview questions.
Results:
Awareness differed depending upon the domain being assessed, with patients demonstrating greatest awareness in the current functional consequences domain. Evidence for a distinction between awareness of current and future functional consequences of impairments was also seen. Discrepancy scores and interviewer-based ratings showed good concordance. Adequate reliability and validity was demonstrated.
Conclusion:
The Insight Interview is a useful and valid tool for measuring awareness in the acute stages following TBI and highlights that awareness depends on domain assessed.
