Patient Competency Rating Scale

(Sherer et al, 2003; n=58 patients with TBI who had emerged from PTA; mean age 33 years; mean PTA duration 28 days) 

• PCRS Clinician-PCRS Patient scores: 
  • <28 mild or no impaired self-awareness 
  • 28-51 moderate impaired self-awareness 
  • >51 severe self-awareness

(Prigatano et al, 1998; n=28; matched controls for individuals with TBI in study by age, sex and education level, mean age 27.4 (9.9) years) 

• Most rated themselves between 130 and 150 on PCRS, closely concurring with ratings by relatives. A smaller percentage of healthy controls (10.7%) overestimated abilities compared to their relatives ratings than individuals with TBI (30%).

(Prigatano et al, 1990; n=17 patients with TBI and their relatives)

• Excellent correlation in two tests for patients (r=.97) and relatives (r=.92) 

(Fleming et al, 1998; n=20 patients with severe TBI; mean age 25(9) years; mean duration of PTA 54(33) days; Australian sample)

• Excellent test-retest reliability one week apart (ICC=.85)

(Fordyce and Roueche,1986; n=28 patients with TBI; ages 19-44; time post injury 3-28 months)

• Excellent interstaff ratings (r=.92)

(Fleming et al, 1998; n=55 patients with severe TBI; mean age 25(9) years; mean duration of PTA 554(33) days; Australian sample)

• Excellent internal consistency for patient and relative versions of PCRS with alphas of .91 and .93 respectively.

Predictive validity:

• PCRS difference scores were better able than Awareness Questionnaire difference scores to predict employability in a regression model (accounting for 22% of variability in employability) (Sherer et al, 2003).

Traumatic brain injury: (Prigatano et al, 1998; n=30; mean age 29(10.4) years; who had sustained TBI with mean GCS 6.6(2.8) and mean PTA of 69.6 (69.5) days; mean time post injury= 24.8 months (14.5)) 

• Agreement of individual ratings and relative ratings differed between the group with brain injury and a group of healthy controls (X2 analysis, p=.0014). 
• Adequate correlation of patient difference scores on PCRS (compared to relative) and admitting GCS (r=-.39) and PTA (r=0.41). 

Traumatic Brain Injury: (Prigatano et al, 2005; n=25, average age 35.1(11.65) years; diagnosed with TBI) 

• Adequate correlation with relatives’ emotional distress (r=-.52) with decreased awareness of deficits identified by individuals with brain injury. 
• The PCRS helped identify recovery patterns in individuals with severe TBI including a group with high self-awareness of TBI deficits who were more emotionally distressed and motivated to improve, in contrast with a group with low self-awareness and lack of distress or motivation to change and a group that had achieved a good recovery, with lack of emotional distress or motivation to change because they had few deficits. (Fleming et al, 1998) 
• Patient rated abilities were not correlated with clinician or family PCRS ratings, reflecting impaired self-awareness; Adequate to excellent correlations for clinician/family PCRS ratings (r=.36) and clinician/family difference scores (r=.64); Excellent correlation of PCRS to Awareness Questionnaire scores (r=.69) (Sherer et al, 2003)