Feedback interventions for impaired self-awareness following brain injury: a systematic review.

Abstract

To determine the effectiveness of self-awareness interventions that involve a component of feedback for adults with brain injury. Systematic review. Randomized and non-randomized studies identified by searching CINAHL, Cochrane Systematic Review Database, Embase, Medline, OTSeeker, PsycBITE, PsycINFO, Web of Science, clinical trial registries, and reference lists of eligible articles. Twelve studies of varied methodological quality met the inclusion criteria, of which 3 were randomized controlled trials involving a total of 62 people with brain injury of mixed aetiology. The type of feedback intervention and outcomes assessed were heterogeneous. The pooled estimate of improvement in self-awareness after completing a feedback intervention was of moderate effect size (Hedges' adjusted g = 0.64; 95% confidence interval: 0.11-1.16). Feedback interventions produced modest improvements in self-awareness. Further research is required to determine the effects of integrating feedback interventions into rehabilitation programmes and the impact of this on functional outcome.