Psychometric evaluation of the Self-Awareness in Daily Life-3 Scale (SADL-3) for the assessment of self-awareness after acquired brain injury

Objective: The Self-Awareness in Daily Life-3 Scale (SADL-3) was designed to assess self-awareness in the chronic phase after acquired brain injury (ABI). The main objective was to evaluate its feasibility and usability for clinical practice, reliability and validity.

Methods: Participants were 89 patients with ABI. SADL-3 core distributions, floor and ceiling effects and percentage of missing items were used. Ratings made by two staff members and ratings at two time points were compared. SADL-3 ratings were compared with Awareness Questionnaire (AQ) ratings, Patient Competency Rating Scale (PCRS) ratings, and ratings made on the Clinician's Rating Scale for evaluating Impaired Self-Awareness and Denial of Disability (CRS-ISA-DD). Staff members completed a questionnaire concerning the usability of the SADL-3.

Results: No floor or ceiling effects were present. Results show sufficient inter-rater reliability (ICC > .40), acceptable test-retest reliability (ρ_s > .75) and sufficient convergent validity (ρ_s > .30). The median administration time was 15 minutes (SD = 21.2). Most staff members rated the SADL-3 as fairly easy to very easy to complete.

Conclusions: The SADL-3 is a brief scale with sufficient psychometric properties. Teams can use it in clinical practice to identify patients' self-awareness in the chronic phase after ABI.