Self-awareness interventions after acquired brain injury: A systematic review and meta-analysis.

IF 1.9 4区医学 Q3 PSYCHOLOGY, CLINICAL Rehabilitation Psychology Pub Date : 2025-01-06 DOI:10.1037/rep0000598

Dolores Villalobos, Umberto Bivona, Juan Botella

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Abstract

Objective: Self-awareness (SA) is a crucial component of the neurorehabilitation processes for persons with acquired brain injury. Specific intervention programs to improve SA have been developed and implemented with heterogeneous results. The current study was undertaken to summarize this evidence by conducting a systematic review of relevant literature and to perform a meta-analysis of the most reliable and important results.

Method: A systematic literature search made in May 2023 across three databases (Web of Science, PubMed, and PsycINFO) resulted in a final selection of 16 primary studies based on 17 different groups.

Results: In an initial meta-analysis, the effect sizes were calculated as the standardized d, that is, pre-post change scores corrected for bias. Using a random-effects model, we obtained a significant mean effect size for the interventions, k = 17, g = 0.6404 [0.411, 0.870] with significant heterogeneity among the studies, Q(16) = 43.06, p < .001, and a significant, but modest publication bias. Moderator analysis showed that the SA intervention efficacy could be improved by "metacognition" as an intervention technique. A second meta-analysis was carried out considering the seven studies with between-subjects designs, and again a significant mean effect size was obtained, k = 7, g = 0.6713 [0.403, 0.94].

Conclusion: Overall, the present study provided positive evidence to support the efficacy of specific SA interventions in adults with acquired brain injury. Further studies are warranted to explore the mechanisms by which SA interventions exert their effects. (PsycInfo Database Record (c) 2025 APA, all rights reserved).

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获得性脑损伤后的自我意识干预：一项系统综述和荟萃分析。

目的：自我意识（SA）是后天性脑损伤患者神经康复过程的重要组成部分。改善SA的具体干预方案已被开发和实施，结果不尽相同。本研究通过对相关文献进行系统回顾，并对最可靠和最重要的结果进行荟萃分析，总结了这一证据。方法：于2023年5月在三个数据库（Web of Science， PubMed和PsycINFO）中进行系统文献检索，最终选择了17个不同组的16项主要研究。结果：在最初的荟萃分析中，效应量以标准化的d来计算，即校正偏差后的改变前得分。使用随机效应模型，我们获得了干预措施的显著平均效应大小，k = 17, g = 0.6404[0.411, 0.870]，研究之间存在显著异质性，Q(16) = 43.06, p < .001，并且存在显著但适度的发表偏倚。调节分析表明，“元认知”作为干预手段，可以提高情景认知干预的效果。对采用受试者间设计的7项研究进行第二次meta分析，同样获得显著的平均效应量，k = 7, g = 0.6713[0.403, 0.94]。结论：总的来说，本研究为支持特异性SA干预对成人获得性脑损伤的疗效提供了积极的证据。需要进一步的研究来探索SA干预发挥其作用的机制。（PsycInfo Database Record (c) 2025 APA，版权所有）。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Rehabilitation Psychology Multiple-

CiteScore

4.80

自引率

7.40%

发文量

期刊介绍： Rehabilitation Psychology is a quarterly peer-reviewed journal that publishes articles in furtherance of the mission of Division 22 (Rehabilitation Psychology) of the American Psychological Association and to advance the science and practice of rehabilitation psychology. Rehabilitation psychologists consider the entire network of biological, psychological, social, environmental, and political factors that affect the functioning of persons with disabilities or chronic illness. Given the breadth of rehabilitation psychology, the journal"s scope is broadly defined.