Identifying denial in stroke patients

The purpose of this study was to test the reliability of an experimental assessment tool for identifying and differentiating between psychodynamic and neurogenic denial in stroke patients. A one-page criterion referenced denial assessment tool was used by interdisciplinary rater teams to evaluate patients with either right or left hemisphere insults. High interrater reliability was obtained. Assessment data indicated that right-CVA patients had higher psychodynamic and neurogenic denial scores than left-CVA patients. Higher psychodynamic denial scores were also observed in the second month post-stroke. The experimental denial assessment tool proved to be a practical way for identifying and differentiating psychodynamic and neurogenic forms of denial. This tool can provide a means for ongoing assessment to support precise nursing diagnoses and promote effective patient-focused care planning throughout the rehabilitation process.