Initial disturbances of consciousness and resultant impaired awareness in Spanish patients with traumatic brain injury

The purpose of this prospective, between-subjects study was to took at impa ired awareness cross-culturally in patients with traumatic brain injury (TB I) and to relate impaired awareness after injury to the initial estimates o f disturbed consciousness at time of injury. The study was conducted in com munity and inpatient and outpatient rehabilitation centers in Barcelona and ;Madrid. Participants were 30 persons with primarily moderate to severe TBI who could complete a written questionnaire concerning their functioning an d 28 age- and gender-matched controls. A Spanish translation of the Patient Competency Rating Scale (PCRS) was administered to each participant. Relat ives or significant others also completed this scale on each participant us ing the relative's version (PCRS-R). Difference scores, Obtained by subtrac ting PCRS-R from PCRS-P (PCRS-P minus PCRS-R), were used as a marker of imp aired awareness. Individuals with TBI were rated (by self and significant o thers) as being less competent than controls. Forty percent of Spanish pati ents with TBI who suffered severe injuries tended to overestimate their beh avioral competencies. The PCRS-P minus the PCRS-R difference scores tended to correlate with admitting Glasgow Coma Scale (GCS) scores and retrospecti ve estimates of posttraumatic amnesia (PTA). Initial disturbances of consci ousness, one measure of severity of brain injury, appeared to relate to lat er measures of impaired self-awareness in Spanish patients with TBI. Non-br ain-injured controls did not tend to report levels of competency that diffe red from their relatives' reports.