Di Somma Rebecca, Fleming Peter
Department of Clinical Psychology, Faculty of Psychological Health, Wellbeing and Social Work, Aire Building, University of Hull, Hull, UK.
Brain Inj. 2024 Dec 5;38(14):1185-1196. doi: 10.1080/02699052.2024.2392161. Epub 2024 Aug 19.
Impaired self-awareness (ISA) is common in individuals with an acquired brain injury (ABI) and can lead to reduced awareness of one's difficulties. Previous reviews have found that ISA impacts on functional outcomes in rehabilitation. However, to date there has not been a systematic literature review which examines how ISA impacts on the process of rehabilitation in ABI populations.
A literature search was conducted using several databases in May 2024, including Academic Search Premier, CINAHL, MEDLINE, APA PsycARTICLES and APA PsycINFO. Seventeen articles were selected for the review and were analyzed using Narrative Synthesis.
Four themes arose from the findings, including goal setting, treatment adherence, engagement and willingness to change and time spent in hospital. ISA was found to impact on the value adult ABI participants placed in rehabilitation, which decreased treatment compliance, motivation, and engagement. ISA also impacted on goal setting and behavior and resulted in a longer length of time spent in hospital.
This review emphasizes the impact of ISA on various aspects/processes of rehabilitation in ABI and provides considerations of how clinicians might adapt interventions to manage these difficulties.
自我意识受损（ISA）在获得性脑损伤（ABI）患者中很常见，可能导致对自身困难的认识降低。以往的综述发现，ISA会影响康复的功能结局。然而，迄今为止，尚未有系统的文献综述探讨ISA如何影响ABI人群的康复过程。
2024年5月使用多个数据库进行了文献检索，包括学术搜索高级版、护理学与健康领域数据库、医学索引数据库、美国心理学会心理学文摘数据库和美国心理学会心理学信息数据库。筛选出17篇文章进行综述，并采用叙述性综合分析方法进行分析。
研究结果产生了四个主题，包括目标设定、治疗依从性、参与度和改变意愿以及住院时间。研究发现，ISA会影响成年ABI参与者对康复的重视程度，进而降低治疗依从性、动机和参与度。ISA还会影响目标设定和行为，并导致住院时间延长。
本综述强调了ISA对ABI康复各个方面/过程的影响，并为临床医生如何调整干预措施以应对这些困难提供了思考。
