Development of the Japanese version of the awareness questionnaire for assessment of self-awareness after acquired brain injury: reliability and validity

ABSTRACT

Background

The evaluation of impaired self-awareness (ISA) after brain injury is not widespread in Japan, and there is a lack of Japanese assessments of self-awareness.

Objectives

To translate the original version of the Awareness Questionnaire (AQ), an instrument for assessing ISA, into Japanese using a validated method and examine its reliability and validity in inpatients with stroke.

Methods

This cross-sectional, prospective study enrolled 130 participants. The double-translation process was used to develop the Japanese version of the AQ.

Results

Data were collected from 120 patients. High intra-rater reliability was observed for the patient (Cronbach’s α = 0.824) and clinician samples (Cronbach’s α = 0.933). High intra- and inter-rater reliability were found for all AQ items [interclass coefficient (ICC) (1, 1) = 0.828, ICC (2, 1) = 0.852, ICC (3, 1) = 0.848]; however, the sub-item analysis revealed only moderate reliability. Validity assessment revealed a low but significant positive correlation (r = 0.209; p < 0.05) between the Japanese version of the AQ and the Japanese version of the Self-Regulation Skills Interview and a low but significant negative correlation (r = 0.197; p < 0.05) between the Japanese version of the AQ and the Mini-Mental State Examination.

Conclusions

The Japanese version of the AQ was developed and applied to stroke patients, but the concept of post-stroke ISA may differ from ISA after traumatic brain injury, highlighting the need for a stroke-specific version of the AQ.

KEYWORDS:

• Self-awareness
• reliability
• validity
• brain injury
• stroke
• neuropsychological assessment
• rehabilitation

Acknowledgments

The authors are grateful to the patients and clinical teams that contributed to this research.

Disclosure statement

The authors have declared no potential conflicts of interest.

Additional information

Funding

The authors received no financial support for the research, authorship, and/or publication of this article.