The relationship between self-awareness (insight) and outcome following acquired brain injury (ABI) is well recognised, but evidence suggests that information regarding brain injury and its cognitive impact is not adequately conveyed to social workers, or appropriately considered when assessing support needs and a person’s capacity to make decisions about their care. The Brain Injury Needs Indicator (BINI) provides a solution, by enabling the valid assessment of the needs of those with brain injuries living in a community setting. This paper investigated associations between impaired insight, functional outcome of brain injury, and level of risk, and validated the use of the BINI as an indicator of need. A high prevalence of severe disability (73 per cent) and low insight (30 per cent) was found in a sample of thirty individuals with ABI. The composite BINI score was the measure most strongly related with a clinical assessment of risk (rs = 0.72, N = 26). Self-report methods may underestimate support needs, especially in those with low levels of insight into their difficulties. The BINI, which combines outcome post-ABI with a measure of insight, provides a more accurate estimate of risk than either measure individually. It is important to include both areas in individual needs assessments.

中文翻译：

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在评估护理需求中考虑功能结果和自我意识的重要性：脑损伤需求指标的初步评估

获得性脑损伤 (ABI) 后自我意识（洞察力）与结果之间的关系已得到广泛认可，但有证据表明，有关脑损伤及其认知影响的信息并未充分传达给社会工作者，或在评估支持需求和一个人对其护理做出决定的能力。脑损伤需求指标 (BINI) 提供了一个解决方案，通过对居住在社区环境中的脑损伤患者的需求进行有效评估。本文调查了洞察力受损、脑损伤的功能结果和风险水平之间的关联，并验证了使用 BINI 作为需求指标。在 30 名 ABI 患者的样本中发现了严重残疾（73%）和低洞察力（30%）的高患病率。综合 BINI 评分是与临床风险评估最密切相关的指标（rs = 0.72，N = 26）。自我报告方法可能会低估支持需求，尤其是对于那些对自己的困难缺乏洞察力的人。BINI 将 ABI 后的结果与洞察力测量相结合，提供比单独测量更准确的风险估计。在个人需求评估中包括这两个领域是很重要的。