| Summary: | <p><strong>Critical Review of Literature: Impaired Self-Awareness Post Brain Injury: A Systematic Review of Self Awareness Outcome Measures</strong></p>
<p>Acquired brain injuries can lead to impairments in physical and cognitive functioning, which are known to impact rehabilitation. Deficits in metacognitive knowledge, information individuals possess about their cognitive capabilities, can cause a lack of self-awareness, leading people to underestimate the impact of their brain injury on their functioning. Measures examining impaired self-awareness do exist, but metacognition is not routinely measured in cognitive assessments.</p>
<p>This systematic review examined the psychometric properties of assessment tools used to measure metacognition in acquired brain injury studies using a Preferred Reporting Items for Systematic Review (PRISMA) and Consensus-based Standards for the selection of health Measurement Instruments (COSMIN) approach.</p>
<p>A database search was conducted, with 2192 records identified. Following screening and assessment for eligibility, 27 studies were included.</p>
<p>Assessments utilised were Patient Competency Rating Scale (PCRS), Self-Awareness of Deficits Interview, (SADI), Awareness Questionnaire (AQ), Dysexecutive Questionnaire (DEX), La Trobe Communication Questionnaire (LCQ), Clinician Rating Scale for Evaluating Impaired Self-Awareness and Denial of Disability (CRS-ISA-DD), Self-Awareness Multilevel Assessment Scale (SAMAS), Self-Regulating Skills Interview (SRSI) and Cognitive Awareness Activities of Daily Living (Cog-ADL), with studies providing variable quality psychometric information.</p>
<p>All measures showed shortcomings regarding their psychometric properties, but overall, it was assessed that the AQ has the highest quality evidence for its psychometric properties, but the PCRS has the most validation studies and can be used in other languages and populations. Future studies should seek to provide more psychometric investigations of these measures rather than reporting previous studies' properties.</p></br>
<p><strong>Service Improvement Project: Mental Health Outcomes of People with Long Term Conditions: An Analysis of Factors that Impact Recovery in Talking Therapy Services</strong></p>
<p>Long-term health conditions (LTCs) are extremely prevalent throughout the population, and those with a LTC are more likely than the rest of the population to have poor mental health outcomes. Primary care services for common mental health conditions, such as Talking Therapy, offer services to people with LTCs, however, their recovery rates are often below that of people without a LTC.</p>
<p>This paper aims to explore the outcome data from LTC clients of a Talking Therapy service to examine the factors that may be affecting their recovery in terms of common mental health problems. In this mixed methods study, service data was collated from clients discharged from January 2022 to January 2023, and qualitative data was gathered using a survey sent to those who accessed the service with a LTC in the last six months.</p>
<p>Quantitative analysis showed that factors that affected recovery included whether clinicians had additional training on the LTC, where the referral came from and the number of different LTCs. Qualitative analysis indicated that clients with a LTC wanted the flexibility of the service (cancellation protocols, length and timings of sessions etc.) to be improved and to see further adaptation of materials to include LTCs more specifically. They noted that the therapist’s validation and empathy were extremely important, and many also noted further factors they wanted to Talking Therapy services that were not within service provision, suggesting expectations of the service need to be managed.</p></br>
<p><strong>Theory Driven Research Project: Mastery and Burden in Caregivers of People with Chronic Obstructive Pulmonary Disease</strong></p>
<p>Chronic Obstructive Pulmonary Disease (COPD) is the leading cause of mortality and morbidity worldwide, but our knowledge of the impact this disease has on caregivers is limited. Studies of caregivers of other conditions, such as dementia, show poor outcomes, with higher levels of caregiver burden associated with anxiety and depression. The Caregiver Stress Process Model helps to understand caregiver stress and suggests factors that can interfere with the process, protecting the caregiver. Mastery is one of these factors and has two aspects; global and caregiver mastery, which have both been shown to be negatively associated with burden, anxiety, and depression in caregivers of other conditions.</p>
<p>This study investigated whether mastery was influential for COPD caregivers. Caregivers were separated into high or low burden groups, and those with high burden showed significantly lower global and caregiver mastery scores than those with low burden. Both global and caregiver mastery explained a significant amount of variance in burden, depression, anxiety, and stress. However, caregiver mastery explained more variance for burden whereas global mastery explained more for the latter three. Both mastery types had a partial mediation effect on depression, anxiety, and stress.</p>
<p>This supports research from other caregiver literature showing the importance of mastery as a protective factor and has important clinical implications for future caregiver interventions.</p>
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