Article

OBJECTIVE: To evaluate the patient's awareness of his or her difficulties in the
chronic phase of severe traumatic brain injury (TBI) and to determine the factors
related to poor awareness. DESIGN : This study was part of a
larger prospective inception cohort study of patients with severe TBI in the
Parisian region (PariS-TBI study). Intervention/Main measures: Evaluation was
carried out at four years and included the Brain Injury Complaint Questionnaire
(BICoQ) completed by the patient and his or her relative as well as the
evaluation of impairments, disability and quality of life. RESULTS: A total of 90
patient-relative pairs were included. Lack of awareness was measured using the
unawareness index that corresponded to the number of discordant results between
the patient and relative in the direction of under evaluation of difficulties by
the patient. The only significant relationship found with lack of awareness was
the subjective burden perceived by the relative (Zarit Burden Inventory) ( r =
0.5; P < 0.00001). There was no significant relationship between lack of
awareness and injury severity, pre-injury socio-demographic data, cognitive
impairments, mood disorders, functional independence (Barthel index), global
disability (Glasgow Outcome Scale), return to work at four years or quality of
life (Quality Of Life after Brain Injury scale (QOLIBRI)). CONCLUSION: Lack of
awareness four years post severe TBI was not related to the severity of the
initial trauma, sociodemographic data, the severity of impairments, limitations
of activity and participation, or the patient's quality of life. However, poor
awareness did significantly influence the weight of the burden perceived by the
relative.

Langue : ANGLAIS