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Rehab Measures: Awareness Questionairre

Link to instrument

http://www.tbims.org/combi/aq 

Title of Assessment

Awareness Questionairre 

Acronym

Instrument Reviewer(s)

Initially reviewed by Karen McCulloch, PT, PhD, NCS and the TBI EDGE task force of the Neurology Section of the APTA in 6/2012

Summary Date

11/27/2012 

Purpose

This tool measures impaired self-awareness after acquired brain injury.

Description

  • The self and family versions of the AQ consist of 17 items, a clinician version consists of 18 items.
  • Each item is rated 5-point scale from “much worse” to “much better”, comparing pre- and post- injury. A score of 3 is “about the same” as pre-injury.
  • Scoring occurs by comparing family or clinician scores to the self-rated scores completed by the person with the brain injury. The total score for family or clinician is subtracted from the total score for the patient. A larger difference indicates greater impairment.
  • Scoring for the additional clinician rating scale (item 18) is a 1-5 rating of severity of awareness deficit (none, minimal, moderate, severe, or complete lack of awareness of deficits).

Area of Assessment

 

Body Part

 

ICF Domain

Activity; Participation 

Domain

 

Assessment Type

 

Length of Test

06 to 30 Minutes 

Time to Administer

10 minutes

Number of Items

All versions have 17 items that are rated in common.  The clinician version has one item that is a global rating of awareness. 

Equipment Required

No equipment required

Training Required

No specific training is required.

Type of training required

No Training 

Cost

Free 

Actual Cost

No charge for the instrument.

Age Range

 

Administration Mode

 

Diagnosis

Acquired Brain Injury; Traumatic Brain Injury 

Populations Tested

  • Acquired Brain Injury
  • Traumatic Brain Injury

Standard Error of Measurement (SEM)

Not Established

Minimal Detectable Change (MDC)

Not Established

Minimally Clinically Important Difference (MCID)

Not Established

Cut-Off Scores

Traumatic Brain Injury: (Evans et al, 2005; n=96; median age 33; admitted to inpatient TBI rehabilitation)

  • Scores range from 17-85 on the AQ, with a 51 estimating “about the same as before injury”.
  • Difference scores (clinician or family subtracted from patient ratings) range from -68 to 68, with higher scores associated with the patient rating him/herself higher.
  • A score of >20 in the difference score has been suggested as indicating clinically significant impairment of self-awareness.

Normative Data

Not Established

Test-retest Reliability

Not Established

Interrater/Intrarater Reliability

Not Established

Internal Consistency

Traumatic Brain Injury:(Sherer et al, 1998a; n=126; mean age 32.3(12.4); average time post injury 10.2 months (21.3))

  • Excellent internal consistency for patient and family ratings alpha=.88

Criterion Validity (Predictive/Concurrent)

Predictive validity:

Traumatic brain injury:(Sherer et al, 1998b; n=66; mean age 31.7(12.2) years, mean time post injury= 8.5 (19.7); mean clinician rating of moderate awareness deficits)

  • Difference in patient and family ratings were significantly associated with employment status 30.2 (22.2) months after injury using a regression model.
  • Differences in ratings between family and patient and single item clinician rating of accuracy of self-awareness predicts productivity outcome. (31% of variance).

Construct Validity (Convergent/Discriminant)

Traumatic Brain Injury: (Sherer et al, 1998c; n= 64; average age 28.8 (9.8) years; average 13.0 (20.8) months post injury)

  • Individuals with brain injury rate themselves as less impaired than do clinicians or family members.
  • Awareness of cognitive and behavioral function is more impaired than awareness of motor and sensory functioning.

Traumatic Brain Injury:(Evans et al, 2005)

  • Adequate correlation with clinician (0.34) and patient (0.39) AQ scores with Satisfaction with Life Scale.

Content Validity

Traumatic Brain Injury:(Sherer et al, 1998a)

  • A factor analysis demonstrated three factors: cognitive (7 items), behavioral/affective (6 items), and motor/sensory (4 items).

Face Validity

Not Established

Floor/Ceiling Effects

Not Established

Responsiveness

Not Established

Professional Association Recommendations

Recommendations for use of the instrument from the Neurology Section of the American Physical Therapy Association’s Multiple Sclerosis Taskforce (MSEDGE), Parkinson’s Taskforce (PD EDGE), Spinal Cord Injury Taskforce (PD EDGE), Stroke Taskforce (StrokEDGE), Traumatic Brain Injury Taskforce (TBI EDGE), and Vestibular Taskforce (VEDGE) are listed below. These recommendations were developed by a panel of research and clinical experts using a modified Delphi process.

 

For detailed information about how recommendations were made, please visit:  http://www.neuropt.org/go/healthcare-professionals/neurology-section-outcome-measures-recommendations

 

Abbreviations:

HR

Highly Recommend

R

Recommend

LS / UR

Reasonable to use, but limited study in target group  / Unable to Recommend

NR

Not Recommended

 

Recommendations based on level of care in which the assessment is taken:

 

Acute Care

Inpatient Rehabilitation

Skilled Nursing Facility

Outpatient

Rehabilitation

Home Health

TBI EDGE

NR

LS

NR

LS

LS

 

Recommendations for use based on ambulatory status after brain injury:

 

Completely Independent

Mildly dependant

Moderately Dependant

Severely Dependant

TBI EDGE

LS

LS

LS

NR

 

 

Recommendations for entry-level physical therapy education and use in research:

 

Students should learn to administer this tool? (Y/N)

Students should be exposed to tool? (Y/N)

Appropriate for use in intervention research studies? (Y/N)

Is additional research warranted for this tool (Y/N)

TBI EDGE

No

No

Yes

Not reported


Considerations

Not Established
Do you see an error or have a suggestion for this instrument summary? Please e-mail us!

Bibliography

Evans, C. C., Sherer, M., et al. (2005). "Early impaired self-awareness, depression, and subjective well-being following traumatic brain injury." Journal of Head Trauma Rehabilitation 20(6): 488-500. Find it on PubMed

Sherer, M., Bergloff, P., et al. (1998). "The Awareness Questionnaire: factor structure and internal consistency." Brain Injury 12(1): 63-68. Find it on PubMed

Sherer, M., Bergloff, P., et al. (1998). "Impaired awareness and employment outcome after traumatic brain injury." J Head Trauma Rehabil 13(5): 52-61. Find it on PubMed

Sherer, M., Boake, C., et al. (1998). "Characteristics of impaired awareness after traumatic brain injury." J Int Neuropsychol Soc 4(4): 380-387. Find it on PubMed

Year published

 

Instrument in PDF Format

Yes 
Approval Status Approved 
 
Attachments
Created at 11/28/2012 8:57 PM  by Jason Raad 
Last modified at 8/29/2014 1:15 PM  by Jason Raad