Stapleton Tadhg, Connolly Deirdre, O'Neill Desmond
Department of Occupational Therapy, Trinity College Dublin, Dublin, Ireland.
Aust Occup Ther J. 2012 Feb;59(1):63-70. doi: 10.1111/j.1440-1630.2011.00980.x. Epub 2011 Dec 28.
BACKGROUND/AIM: The inclusion of a driving specific self-awareness measure may assist the clinical screening process to determine fitness to drive after stroke. This article reports on the use of the Adelaide Driving Self-Efficacy Scale (ADSES) and a proxy ADSES for completion by a significant other in assessment of fitness to drive post-stroke.
A prospective study among a clinical sample of stroke patients was conducted incorporating an off-road occupational therapy assessment, an on-road assessment and a six-month follow-up. Self and proxy driver efficacy ratings were compared with each other at off-road assessment and at six-month follow-up, both ratings were compared with structured on-road ratings of driving performance.
Forty-six stroke patients (37 men), mean age 63.5 years, were recruited to the study. Thirty-five participants successfully completed the on-road test. ADSES and proxy ratings were high and a ceiling effect was noted. Self and proxy ratings were significantly correlated with each other and both correlated with the on-road assessment ratings. The ADSES ratings were sensitive to the final driving outcome with scores of the restricted driving group significantly lower than the unrestricted group. Proxy ratings showed a decrease at six-month follow-up.
The ADSES is an easy to administer tool that warrants further use in stroke rehabilitation. Scores on the ADSES differentiated between restricted and unrestricted driving recommendations post-stroke. These preliminary findings indicate its potential use as a proxy measure to assist in identifying patient who are not ready for formal driving assessment.
背景/目的：纳入一项针对驾驶的特定自我意识测量方法可能有助于临床筛查过程，以确定中风后是否适合驾驶。本文报告了阿德莱德驾驶自我效能量表（ADSES）以及由重要他人完成的代理ADSES在评估中风后驾驶适合性中的应用。
对一组中风患者临床样本进行前瞻性研究，纳入非道路职业治疗评估、道路评估以及为期6个月的随访。在非道路评估和6个月随访时，将自我和代理驾驶员效能评分进行相互比较，并将这两种评分与结构化的道路驾驶性能评分进行比较。
46例中风患者（37名男性），平均年龄63.5岁，被纳入该研究。35名参与者成功完成了道路测试。ADSES和代理评分较高，且存在天花板效应。自我评分与代理评分显著相关，且二者均与道路评估评分相关。ADSES评分对最终驾驶结果敏感，受限驾驶组的得分显著低于非受限组。代理评分在6个月随访时有所下降。
ADSES是一种易于实施的工具，值得在中风康复中进一步应用。ADSES评分区分了中风后受限和非受限驾驶建议。这些初步研究结果表明其作为一种代理测量方法，有潜力用于识别尚未准备好接受正式驾驶评估的患者。
