A University of Queensland clinical senior lecturer in occupational therapy has won a national award for a study of the self-awareness of deficits in severely brain-injured adults.
Dr Jennifer Fleming received the OT (Occupational Therapy) Australia Experienced Research Award for her PhD paper at a national occupational therapy conference in April.
Occupational Therapy Department head Associate Professor Jenny Strong and Dr Roderick Ashton, of the Psychology Department, supervised the research. Dr Fleming received her degree in December.
Dr Fleming assessed 55 patients at three, six, nine and 12 months after severe traumatic brain injury to determine awareness of their problems.
About 70 percent of injuries resulted from motor vehicle accidents. Other causes of injury included assault, falls and horse-riding and pedestrian accidents.
The study sample of patients aged 15 to 65 excluded those who were still confused or semi-comatose at three months after injury. About half had returned to the workforce three months after injury.
Dr Fleming developed a structured interview format to assess self-awareness. This has now been adopted as an assessment tool for occupational therapy assessments at the Princess Alexandra Hospital where Dr Fleming is assistant director of the Hospital's Occupational Therapy Department.
'Patients with limited awareness of problems aren't motivated to participate in rehabilitation because they don't accept that their problems exist,' Dr Fleming said.
'Those who continually deny or minimise problems won't master activities as easily as those who acknowledge their limitations.
'Those without insight into their problems are less willing to adopt compensatory strategies such as using a diary for memory problems or modifying work routines.'
Dr Fleming said that self-awareness improved over 12 months in nearly all cases but some patients became depressed as their self-awareness improved. However the development of self-awareness was related to a better outcome from rehabilitiation.
She said personality could be a key factor in self-awareness.
Her research found no significant relationship between self-awareness and memory.
Dr Fleming now plans to develop a structured program to facilitate self-awareness.
'There's also a need to address the timing of rehabilitation. Some patients may recognise problems more than 12 months after injury, when they're outside the rehabilitation system,' she said.
'Patients with severe traumatic brain injury may make reasonable physical recovery but most have difficulty living independently and organising their lives.
'They experience cognitive functioning problems such as memory loss and poor problem-solving and attention skills. They may also experience social and behavioural problems such as impulsive, immature behaviour and lack of emotional control.'
Dr Fleming's work at the Hospital includes supporting staff in clinical research and co-ordinating clinical work for University of Queensland students.
Dr Fleming, a 1987 University medallist, received a prestigious Sir Robert Menzies Scholarship in allied health sciences in 1993 and an Australian Postgraduate Award in 1995 to assist completion of her PhD studies.
For more information, contact Dr Fleming (telephone 07 3240 5008).
