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RESEARCH ARTICLE (Open Access)
Contents Vol 24(3)

Self- and observer ratings of capacity limitations in patients with neurological conditions

Anne Henning A B * , Michael Linden C and Beate Muschalla A B
+ Author Affiliations
- Author Affiliations

A Department of Psychotherapy and Diagnostics, Technische Universität Braunschweig, Braunschweig, Germany

B Brandenburgklinik Berlin-Brandenburg, Bernau bei Berlin, Germany

C Research Group Psychosomatic Rehabilitation, Charité - Universitätsmedizin Berlin, Berlin, Germany

* Correspondence to: anne.henning@charite.de

Brain Impairment 24(3) 586-600 https://doi.org/10.1017/BrImp.2022.26
Submitted: 23 October 2021  Accepted: 10 October 2022  Published: 17 November 2022

© The Author(s), 2022. Published by Cambridge University Press on behalf of Australasian Society for the Study of Brain Impairment. This is an Open Access article, distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivatives licence (https://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial re-use, distribution, and reproduction in any medium, provided the original work is unaltered and is properly cited. The written permission of Cambridge University Press must be obtained for commercial re-use or in order to create a derivative work.

Abstract

Objective:

The purpose of this study was to compare the self- and observer ratings of capacity limitations in patients with neurological conditions. Research on this topic is relevant for assessing the patients’ ability to participate in work and social life and improving collaborative patient-clinician relationships.

Method:

The self- and observer ratings of capacity limitations in a sample of N = 245 patients with neurological conditions from a rehabilitation facility were compared and assessed using the short rating of activity limitations and participation restrictions in mental disorders according to the International Classification of Functioning, Disability and Health (Mini-ICF-APP) and the equivalent self-rating questionnaire (Mini-ICF-APP-S).

Results:

Paired-samples t-tests revealed significant differences between the self- and observer ratings for six out of 13 capacity dimensions. On average, the patients rated the capacity dimensions adherence to regulations, planning and structuring of tasks, professional competency and endurance as significantly less limited, in comparison to the observers (small to medium effect sizes). The self-ratings for limitation of contact with others and self-care were only marginally higher than the observer ratings.

Conclusions:

The findings show that psychological capacity limitations occur in patients with neurological conditions. In clinical practice, limitations in each capacity dimension and discrepancies in patient- and clinician-ratings should be thoroughly assessed. This is especially relevant in patients with neurological conditions who have a potential tendency to underestimate or deny their disability.

Keywords: Capacity limitation, Mini-ICF-APP, self- and observer rating, neurological conditions, rehabilitation, socio-medical assessments, self-awareness.

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