Brief Report
Issue Date: January/February 2018
Published Online: December 01, 2017
Updated: April 30, 2020
Self-Awareness and Recovery of Independence With Strategy Training
Elizabeth R. Skidmore; Melissa Swafford; Shannon B. Juengst; Lauren Terhorst
Author Affiliations
  • Elizabeth R. Skidmore, PhD, OTR/L, is Professor and Chair, Department of Occupational Therapy and Department of Physical Medicine and Rehabilitation, University of Pittsburgh, Pittsburgh, PA; skidmore@pitt.edu
  • Melissa Swafford, MOT, OTR/L, is K. Leroy Irvis Fellow, Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA
  • Shannon B. Juengst, PhD, CRC, is Assistant Professor, Department of Physical Medicine and Rehabilitation, University of Texas Southwestern Medical Center, Dallas
  • Lauren Terhorst, PhD, is Associate Professor, Department of Occupational Therapy, University of Pittsburgh, Pittsburgh, PA
Article Information
Neurologic Conditions / Rehabilitation, Participation, and Disability / Stroke / Columns: Brief Report
Brief Report   |   December 01, 2017
Self-Awareness and Recovery of Independence With Strategy Training
American Journal of Occupational Therapy, December 2017, Vol. 72, 7201345010. https://doi.org/10.5014/ajot.2018.023556
American Journal of Occupational Therapy, December 2017, Vol. 72, 7201345010. https://doi.org/10.5014/ajot.2018.023556
Abstract

OBJECTIVE. Poor self-awareness co-occurs with cognitive impairments after stroke and may influence independence in daily activities. Strategy training promotes independence after stroke, but poor awareness may attenuate treatment response. We examined the degree to which awareness status affected changes in independence attributed to strategy training.

METHOD. We conducted a secondary analysis of 30 participants with cognitive impairments after acute stroke randomized to strategy training or attention control in addition to typical inpatient rehabilitation. We measured awareness with the Self-Awareness of Deficits Interview and independence with the FIM™. Data were analyzed using general linear models.

RESULTS. Poor awareness attenuated improvements in independence over time, F(3, 55) = 3.04, p = .038. Strategy training promoted greater improvements in independence over time relative to attention control, F(3, 55) = 5.93, p = .002. However, the interaction between awareness and intervention was not significant, F(1, 19) = 0.025, p = .877.

CONCLUSION. Awareness status may not affect the response to strategy training, indicating that strategy training may benefit people with poor awareness.