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Measurement Characteristics and Clinical Utility of the Awareness Questionnaire in Individuals With Traumatic Brain Injury

Published:February 04, 2018DOI:https://doi.org/10.1016/j.apmr.2017.12.002
      Traumatic brain injury (TBI) is an injury that disrupts normative function of the brain by means of a bump, blow, or jolt to the head and ranges in severity from mild (concussion) to severe.1 Approximately 30% of all injury deaths are caused by TBI.1 Patients with TBI often demonstrate impaired awareness to their limitations, which leads to low motivation for treatment.2 The Awareness Questionnaire (AQ) is an assessment developed to measure the awareness of patients with TBI in terms of cognitive, behavioral/affective, and motor/sensory characteristics. The AQ focuses on differences in functioning pre- and postinjury. The AQ is administered to the patient and a family member or clinician. The patient and family member versions have 17 items, whereas the clinician version contains 18 items.3 Each question is scored on a 5-point Likert-type scale with answers ranging from much worse to much better after injury.4 Differences between patient-clinician scores and patient-family scores are calculated to assess awareness; higher difference scores indicate lower awareness of limitations. The AQ has adequate construct and criterion validity,3. 5. 6. 7. 8. adequate to excellent test-retest reliability,4 and excellent internal consistency.2. 4. Administration of the AQ is free and simple, requiring <10 minutes, and only involves the questions themselves. The Traumatic Brain Injury Taskforce states that the tool is appropriate for use in intervention research studies. The assessment can be found on the TBI Model Systems website created by the Center for Outcome Measurement in Brain Injury.3
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