Awareness of cognitive abilities in the execution of activities of daily living after acquired brain injury: an evaluation protocol

Abstract

IntroductionOne of the main limitations that can be observed after acquired brain injury (ABI) is the alteration of the awareness of the deficits that can occur in the cognitive skills necessary for performing activities of daily living (ADL). According to the Dynamic Comprehensive Model of Awareness (DCMA), consciousness is composed of offline component, which contains the information stored about characteristics of the tasks and stable beliefs about one’s own capabilities and online awareness, which is activated in the context of the performance of a specific task. The main objective of this project was to generate and validate a detailed cognitive assessment protocol within the context of ADL to evaluate the components of DCMA.Methods and analysisThe proposed protocol consists of two ecological tools: The Cog-Awareness ADL Scale to measure offline component and the Awareness ADL-task: Basic and Instrumental ADL performance-based test to measure online awareness. The aim is to identify the presence of cognitive deficits and anosognosia in patients with ABI within the context of everyday life activities. These two measures will be administered to a group of patients with ABI. In addition, these participants will complete another series of classic tests on anosognosia and cognitive functions in order to find the convergent validity of the two tests proposed in this protocol. The external validity of the Cog-Awareness ADL Scale and the relationships between awareness components within the same ADL domain will be also analysed.Ethics and disseminationThis study was approved by the Ethics Committee of Biomedical Research of Andalusia, on 13 January /2017 (Proceeding 1/2017). All participants are required to provide written informed consent. The findings from this will be disseminated via scientific publication.Trial registration numberNCT03712839.

Identifying conflict monitoring as a key executive component related to impaired self-awareness.

“…The participants completed the "Breakfast and Dressing Conflict Task" (Merchán-Baeza et al, 2020;Ricchetti et al, in press) as part of an evaluation protocol developed in our laboratory to measure online SA within the context of an instrumental activity of daily living. The protocol includes two ADL-based tasks: the Breakfast Task (making an orange juice and a butter and jelly toast) and the Dressing Task (dressing the upper part of the body to go out in a rainy day).…”

“…The performance was video recorded and subsequently assessed by two independent raters using a sophisticated classification that relies on the ability of patients to detect and correct their own errors and/or to solve conflicting situations while performing the task. The percentage of detected errors was calculated as the sum of all errors and conflicting situations that the participant detected divided by the total amount of errors performed and conflicting situations presented in the task (Merchán-Baeza et al, 2020;Ricchetti et al, in press). This variable was used as a measure of the participants' online SA.…”

Linguistic Interference in Reading Stroop Card

“…Cognitive function refers to an individual's perception, memory, thinking, reasoning, language and awareness. 1,2 Stroop test is a part of the cognitive function assessment in Neuropsychology. 3 It assesses the awareness or selective attention of an individual on color interference.…”