Hellebrekers Danique, Winkens Ieke, Kruiper Suzanne, Van Heugten Caroline
a Department of Psychiatry and Neuropsychology, School for Mental Health and Neuroscience , Maastricht University Medical Center , Maastricht , the Netherlands.
d Limburg Brain Injury Center , Maastricht University , Maastricht , the Netherlands.
Brain Inj. 2017;31(11):1469-1478. doi: 10.1080/02699052.2017.1377350. Epub 2017 Oct 5.
Lack of self-awareness of impairments is common after acquired brain injury (ABI). We evaluated the psychometric properties of three commonly used instruments for measuring self-awareness: Awareness Questionnaire (AQ), Patient Competency Rating Scale (PCRS) and Dysexecutive questionnaire (DEX).
We recruited 105 patients with ABI and their relatives. We determined feasibility, responsiveness, test- retest reliability, internal consistency, and construct validity of AQ, PCRS and DEX.
No floor or ceiling effects were present. Total scale scores showed sufficient responsiveness: effect sizes were moderate to large (.57-.85); test-retest reliability was sufficient for patient forms (.75- .88) but mixed for relative forms (.60-.66). Internal consistency was good (.80-.89). Construct validity results confirmed a three-factor structured AQ and a four-factor structured PCRS. A two-facture structure was found for DEX patient forms; a three-factor structure was found for relative forms.
Overall, the total scale scores of patient forms of all questionnaires demonstrated sufficient psychometric properties. Psychometric properties of subscales are questionable. We could not replicate the factor structures of AQ, PCRS and DEX: the items within subscales differed with previous findings. Additional research into the test-retest, inter-rater reliability and responsiveness of relative and clinician forms is required.
后天性脑损伤（ABI）后缺乏对损伤的自我意识很常见。我们评估了三种常用的自我意识测量工具的心理测量特性：意识问卷（AQ）、患者能力评定量表（PCRS）和执行功能障碍问卷（DEX）。
我们招募了105名ABI患者及其亲属。我们确定了AQ、PCRS和DEX的可行性、反应性、重测信度、内部一致性和结构效度。
不存在地板效应或天花板效应。总量表得分显示出足够的反应性：效应大小为中等至较大（0.57 - 0.85）；患者问卷的重测信度足够（0.75 - 0.88），但亲属问卷的重测信度参差不齐（0.60 - 0.66）。内部一致性良好（0.80 - 0.89）。结构效度结果证实了AQ为三因素结构，PCRS为四因素结构。DEX患者问卷为二因素结构；亲属问卷为三因素结构。
总体而言，所有问卷患者版的总量表得分显示出足够的心理测量特性。分量表的心理测量特性值得怀疑。我们无法复制AQ、PCRS和DEX的因子结构：分量表中的项目与先前的研究结果不同。需要对亲属版和临床医生版问卷的重测信度、评分者间信度和反应性进行进一步研究。
