Background: Self-awareness is a significant predictor of neurorehabilitation process and outcome and encompasses metacognitive knowledge and online awareness. The literature focuses primarily on intellectual awareness and research on online awareness is lacking.
Objective: To examine online awareness for functional tasks, how it is affected by task experience and its relationships with neurogenic and psychogenic factors.
Methods: Thirty six adults with ABI attending neurorehabilitation participated in this study. Online awareness was measured as the discrepancy between subjective ratings of performance and performance on functional tasks, as rated by experienced therapists. Participants' ratings were recorded before and immediately after task experience, as well as following a mediated review of task steps. The Impaired Self-Awareness scale (ISA) and the Denial of Disability scale (DD) rated neurogenic and psychogenic mechanisms of unawareness.
Results: Results indicated significant differences between therapists' and participants' ratings before and after IADL task performance, and following mediation. Participants typically overestimated their functional independence and did not significantly change their ratings after task experience. Significant moderate to strong correlations were found between online awareness measures and both DD and ISA scales.
Conclusions: Overestimation of functional independence is common in persons with ABI, is related to both neurogenic and psychogenic factors and is not significantly affected by single task experience. Further studies are required to examine the effect of theoretically driven awareness interventions in neurorehabilitation.
Keywords: ABI; Online awareness; neurorehabilitation; task performance.