Abstract for presentation at 6th World Congress on Brain Injury

Individuals who have incurred a severe acquired brain injury (ABI) commonly require extensive rehabilitation in order to regain optimal function. When an individual experiences deficit unawareness as the result of an ABI, engagement in the rehabilitation process is challenging. Deficit unawareness in ABI has been difficult to understand in terms of etiology and prognosis, and subsequently difficult to manage in rehabilitation. Despite differing views and limited research, it is generally acknowledged clinically, that awareness of deficits is crucial to rehabilitation success. The purpose of this study was to gain insight into the experience of young adults with ABI, as awareness of their deficits emerges. A phenomenological approach was selected, in order to explore the essence of such an experience and its impact on occupational performance, using the perspectives of these individuals. Six participants with ABI, who had been receiving rehabilitation in a community setting and presented with varying degrees of emerging deficit awareness, were selected for the study. A semi-structured interview was conducted with the participants and their responses were analyzed according to a recognized qualitative format. Four predominant themes were identified and discussed. A number of implications of these findings, as they impact individuals with ABI and others involved in their care, were determined. The importance of sensitivity to highly valued roles, experiential learning, role modification and therapeutic alliance was emphasized. Further research is recommended, in order to better understand the complex phenomenon of deficit unawareness and how it can be addressed using therapeutic interventions. Qualitative methodology is advocated to further investigate how we as rehabilitation professionals, can tailor our approaches to intervention, in order to effectively facilitate the emergence of deficit awareness in ABI.