Lloyd Owen, Ownsworth Tamara, Fleming Jennifer, Zimmer-Gembeck Melanie J
a School of Applied Psychology and Menzies Health Institute of Queensland , Griffith University , Brisbane , Australia.
b Queensland Paediatric Rehabilitation Service, Lady Cilento Children's Hospital , Children's Health Queensland , Brisbane , Australia.
Child Neuropsychol. 2018 Jul;24(5):702-722. doi: 10.1080/09297049.2017.1332173. Epub 2017 May 23.
There is a lack of validated measures for assessing self-awareness of deficits after pediatric traumatic brain injury (TBI). The current study aimed to develop and examine the psychometric properties of the Paediatric Awareness Questionnaire (PAQ), and investigate factors related to self-awareness. The PAQ was administered to 32 children aged 8-16 years with mild to severe TBI (72% male, M age = 11.75, SD = 2.9), their parents, and treating clinicians, and to 32 age- and gender-matched typically developing controls and their parents. Children with TBI and their parents also completed the Knowledge of Injury Checklist (KIC), and parents completed the Depression Anxiety and Stress Scale 21. The PAQ was found to have fair to excellent (α = .79-.97) internal consistency for all versions across both groups and good concordance between parent and clinician total scores (ICC = .78). There was also evidence of convergent validity between the PAQ and KIC for both child (r = -.45, p < .05) and parent ratings (r = -.66, p < .001). Poorer self-awareness was significantly related to younger age at injury for the TBI group and lower parental education for the total sample. ANCOVA identified that children with TBI demonstrated significantly poorer awareness than controls after controlling for parental education. Children with TBI typically overestimated their functioning compared to their parents, whereas typically developing children tended to rate their functioning lower than their parents. These findings provide preliminary support for the reliability and validity of the PAQ for assessing self-awareness after pediatric TBI.
目前缺乏用于评估小儿创伤性脑损伤（TBI）后缺陷自我意识的有效测量方法。本研究旨在开发并检验儿童意识问卷（PAQ）的心理测量特性，并调查与自我意识相关的因素。对32名年龄在8至16岁、患有轻度至重度TBI的儿童（72%为男性，平均年龄 = 11.75，标准差 = 2.9）、他们的父母和治疗临床医生，以及32名年龄和性别匹配的发育正常的对照儿童及其父母进行了PAQ测试。患有TBI的儿童及其父母还完成了损伤知识清单（KIC），父母完成了抑郁焦虑压力量表21。结果发现，PAQ所有版本在两组中的内部一致性良好至优秀（α = 0.79 - 0.97），父母和临床医生的总分之间具有良好的一致性（组内相关系数 = 0.78）。还有证据表明，PAQ与KIC在儿童（r = -0.45，p < 0.05）和父母评分（r = -0.66，p < 0.001）方面都具有收敛效度。自我意识较差与TBI组受伤时年龄较小以及总样本中父母教育程度较低显著相关。协方差分析表明，在控制父母教育程度后，患有TBI的儿童的意识明显比对照组差。与父母相比，患有TBI的儿童通常高估自己的功能，而发育正常的儿童往往对自己功能的评分低于他们的父母。这些发现为PAQ在评估小儿TBI后自我意识方面的可靠性和有效性提供了初步支持。
