Abstract
IMPORTANCE: Self-awareness of deficits, or the ability to understand the effects of impairments on daily life, is often diminished after a stroke. Diminished self-awareness influences participation in rehabilitation and functional outcomes. OBJECTIVE: To examine whether self-awareness of deficits changed over time after a stroke (N = 43) and whether metacognitive strategy training (n = 21) resulted in improved self-awareness compared with direct skill training (n = 22). DESIGN: Secondary analysis of data collected from a randomized controlled trial. SETTING: Inpatient stroke rehabilitation. PARTICIPANTS: Adults with cognitive impairments after an acute stroke. INTERVENTION: Metacognitive strategy training is an approach in which clients are guided through a process of self-assessment and develop solutions for barriers to task performance. This approach was compared with direct skill training, in which the therapist provides specific instructions for task completion, removing the client-initiated assessment and problem-solving components. OUTCOMES AND MEASURES: Self-awareness measures included the Self-Regulation Skills Interview and Self-Awareness of Deficits Interview at baseline and 3 mo and 6 mo after the intervention. We used a one-way analysis of variance (ANOVA) to analyze change in self-awareness and a two-way ANOVA to examine differences between groups over time. RESULTS: There was a statistically significant and potentially meaningful difference over time in the self-awareness domain of strategy behavior, F(2) = 3.35, p = .039, but there were no differences in improvements between the metacognitive strategy and direct skill training groups. Conclusions and Relevance: Self-awareness warrants further investigation to determine whether it improves naturally over time or through both interventions after stroke. WHAT THIS ARTICLE ADDS: Self-awareness of deficits, and the use of strategies in particular, may improve in the early stages of stroke recovery, but the optimal approach for intervention remains unclear.
| Original language | English (US) |
|---|---|
| Journal | The American journal of occupational therapy : official publication of the American Occupational Therapy Association |
| Volume | 73 |
| Issue number | 3 |
| DOIs | |
| State | Published - May 1 2019 |
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ASJC Scopus subject areas
- Occupational Therapy
Cite this
Effect of Strategy Training on Self-Awareness of Deficits After Stroke. / Kersey, Jessica; Juengst, Shannon B; Skidmore, Elizabeth.
In: The American journal of occupational therapy : official publication of the American Occupational Therapy Association, Vol. 73, No. 3, 01.05.2019.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Effect of Strategy Training on Self-Awareness of Deficits After Stroke
AU - Kersey, Jessica
AU - Juengst, Shannon B
AU - Skidmore, Elizabeth
PY - 2019/5/1
Y1 - 2019/5/1
N2 - IMPORTANCE: Self-awareness of deficits, or the ability to understand the effects of impairments on daily life, is often diminished after a stroke. Diminished self-awareness influences participation in rehabilitation and functional outcomes. OBJECTIVE: To examine whether self-awareness of deficits changed over time after a stroke (N = 43) and whether metacognitive strategy training (n = 21) resulted in improved self-awareness compared with direct skill training (n = 22). DESIGN: Secondary analysis of data collected from a randomized controlled trial. SETTING: Inpatient stroke rehabilitation. PARTICIPANTS: Adults with cognitive impairments after an acute stroke. INTERVENTION: Metacognitive strategy training is an approach in which clients are guided through a process of self-assessment and develop solutions for barriers to task performance. This approach was compared with direct skill training, in which the therapist provides specific instructions for task completion, removing the client-initiated assessment and problem-solving components. OUTCOMES AND MEASURES: Self-awareness measures included the Self-Regulation Skills Interview and Self-Awareness of Deficits Interview at baseline and 3 mo and 6 mo after the intervention. We used a one-way analysis of variance (ANOVA) to analyze change in self-awareness and a two-way ANOVA to examine differences between groups over time. RESULTS: There was a statistically significant and potentially meaningful difference over time in the self-awareness domain of strategy behavior, F(2) = 3.35, p = .039, but there were no differences in improvements between the metacognitive strategy and direct skill training groups. Conclusions and Relevance: Self-awareness warrants further investigation to determine whether it improves naturally over time or through both interventions after stroke. WHAT THIS ARTICLE ADDS: Self-awareness of deficits, and the use of strategies in particular, may improve in the early stages of stroke recovery, but the optimal approach for intervention remains unclear.
AB - IMPORTANCE: Self-awareness of deficits, or the ability to understand the effects of impairments on daily life, is often diminished after a stroke. Diminished self-awareness influences participation in rehabilitation and functional outcomes. OBJECTIVE: To examine whether self-awareness of deficits changed over time after a stroke (N = 43) and whether metacognitive strategy training (n = 21) resulted in improved self-awareness compared with direct skill training (n = 22). DESIGN: Secondary analysis of data collected from a randomized controlled trial. SETTING: Inpatient stroke rehabilitation. PARTICIPANTS: Adults with cognitive impairments after an acute stroke. INTERVENTION: Metacognitive strategy training is an approach in which clients are guided through a process of self-assessment and develop solutions for barriers to task performance. This approach was compared with direct skill training, in which the therapist provides specific instructions for task completion, removing the client-initiated assessment and problem-solving components. OUTCOMES AND MEASURES: Self-awareness measures included the Self-Regulation Skills Interview and Self-Awareness of Deficits Interview at baseline and 3 mo and 6 mo after the intervention. We used a one-way analysis of variance (ANOVA) to analyze change in self-awareness and a two-way ANOVA to examine differences between groups over time. RESULTS: There was a statistically significant and potentially meaningful difference over time in the self-awareness domain of strategy behavior, F(2) = 3.35, p = .039, but there were no differences in improvements between the metacognitive strategy and direct skill training groups. Conclusions and Relevance: Self-awareness warrants further investigation to determine whether it improves naturally over time or through both interventions after stroke. WHAT THIS ARTICLE ADDS: Self-awareness of deficits, and the use of strategies in particular, may improve in the early stages of stroke recovery, but the optimal approach for intervention remains unclear.
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UR - http://www.scopus.com/inward/citedby.url?scp=85066827515&partnerID=8YFLogxK
U2 - 10.5014/ajot.2019.031450
DO - 10.5014/ajot.2019.031450
M3 - Article
VL - 73
JO - American Journal of Occupational Therapy
JF - American Journal of Occupational Therapy
SN - 0272-9490
IS - 3
ER -