Measuring unawareness of deficits among patients with traumatic brain injury: reliability and validity of the Patient Competency Rating Scale--Hebrew version.

BACKGROUND Unawareness of deficits is a frequent symptom of traumatic brain injury (TBI), affecting motivation and compliance with treatment. The goal of this study was to validate a Hebrew version of the most commonly used measure of post-TBI unawareness of deficits: the Patient Competency Rating Scale (PCRS). METHOD Seven groups of participants were studied: Patients with TBI (two groups), their family members, their therapists (two groups), and matched controls and their family members. The PCRS scores of patients, relatives and therapists were analyzed. RESULTS The adapted scale shows adequate inter-item consistency coefficients, similar to those reported with the original version, and high inter-rater reliability. As expected, the scale significantly differentiates between patients and controls, shows high positive correlations with depression and is composed of the four expected awareness factors. Normative data are also presented. LIMITATIONS The number of participants in each of the seven study groups and the specificity of the stage at which the patients were examined may limit the generalization power of our findings. CONCLUSIONS The Hebrew version of the PCRS is a reliable and valid scale for measuring post-TBI deficits in self-awareness and may be used for clinical and research purposes.