Changes in perspectives of disability among patients, staff, and relatives during rehabilitation of brain injury.

The Insight Interview: A new tool for measuring deficits in awareness after traumatic brain injury

“…It must be noted, however, that, while clinician and family informant ratings were generally not significantly different from each other, family informants overall tended to rate the patients as more impaired than clinicians did. The lower ratings by family informants may be an influence of the emotional distress and trauma the family informants would feel over the injury and seeing their loved ones in the hospital setting [24,50]. Unfortunately, the emotional distress of family informants was not measured in this study and should be a focus of future research.…”

“…It is assumed that patients with awareness deficits will rate their abilities higher or as more intact than the standard and the discrepancy between the patient's selfratings and the standard is considered a measure of the extent of the patient's awareness deficits. External standards to which patients' self-ratings are generally compared include; a family informant's ratings of that patient's functioning [17,19,[24][25][26], a treating clinician's ratings of that patient's functioning [24][25][26][27] and scores on standardized measures of neuropsychological functioning [28][29][30]. As expected, studies using this discrepancy method have generally found that, following TBI, a patient's self-ratings of their functioning is higher (i.e.…”

Cognitive impairment as barrier to engagement in vocational services among veterans with severe mental illness

“…Efforts to include cognitive impairment in the diagnostic criteria of SMI have emphasized benefits such as increasing provider awareness about the important role of cognition in the management and treatment of individuals with SMI [23,[52][53][54]. Successful employment has been associated with significant benefits for those with SMI, including improvements in psychiatric symptoms, lower rates of psychiatric hospitalizations, and reduced social stigma [2,4,[55][56][57][58]. Those with both SMI and cognitive impairment are less likely to reap these rewards because of greater delays in entry to VS but may derive great benefit from additional supports to obtain needed VS.…”

“…Those with SMI often display discrepancies in their perception of VS needs relative to care providers and family members [57][58][59][60]. One study found only modest correlations between individuals with SMI and case manager ratings on perceived need for VS [61].…”

Cognitive rehabilitation versus day treatment in head-injured adults: Is there an impact on emotional and psychosocial adjustment?

“…Brooks, et al [I11 argued that head-injured individuals tended to under-report their cognitive deficits and emotional problems by 20% in comparison to relatives. The effect of such discrepancies on rehabilitation outcome has been discussed [12,13]. Based on these results, we thought it of value to include both patient and relative ratings before and after treatment.…”