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Article type: Research Article
Authors: Rubin, Evana; b | Klonoff, Pamelaa | Perumparaichallai, Ramaswamy Kavithaa; *
Affiliations: [a] The Center for Transitional Neuro-Rehabilitation, Barrow Neurological Institute, St. Joseph’s Hospital and Medical Center, Phoenix, AZ, USA | [b] Bryn Mawr Rehab Psychology Associates, Main Line Health Care, Malvern, PA, USA
Correspondence: [*] Address for correspondence: Kavitha Perumparaichallai, PhD, 222 W. Thomas Road, Suite 401, Phoenix, AZ 85013, USA. Tel.: +1 602 406 3473; E-mail: [email protected].
Abstract: BACKGROUND:Caregiver burden is experienced by a significant number of caregivers of survivors of acquired brain injury (ABI). It is known that self-awareness can impact functioning following ABI. However, the impact of self-awareness on caregiver burden has not been established. OBJECTIVE:To investigate the relationship between self-awareness and caregiver burden following ABI. METHODS:We studied 57 patient-caregiver pairs up to 28 years post-discharge from a post-acute comprehensive holistic milieu-oriented neurorehabilitation program. The Mayo-Portland Adaptability Inventory-4 (MPAI-4) was completed by survivors of ABI and their caregivers. Discrepancies in reports between survivors of ABI and their caregivers were used to determine self-awareness. Additionally, caregivers completed the Zarit Burden Interview (ZBI). RESULTS:Survivors of ABI with impaired self-awareness reported significantly higher levels of functioning than survivors of ABI with unimpaired self-awareness (p < 0.001). Unimpaired self-awareness (p < 0.001) and lower survivor self-reported MPAI-4 Total Score (p < 0.001) significantly predicted caregiver burden. CONCLUSIONS:Survivors of ABI’s level of functioning and their level of self-awareness significantly impacted caregiver burden. Survivors of ABI with impaired self-awareness not only lack insight into their functional abilities but also tend to overestimate their capabilities; this likely contributes to the need for greater levels of supervision and worsened caregiver burden.
Keywords: Anosognosia, awareness, brain injuries, neurological rehabilitation, caregivers
DOI: 10.3233/NRE-203093
Journal: NeuroRehabilitation, vol. 46, no. 4, pp. 511-518, 2020
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