Chua Michelle, McCluskey Annie, Smead Janice M
Discipline of Occupational Therapy, The University of Sydney, Lidcombe, NSW, Australia.
Aust Occup Ther J. 2012 Apr;59(2):121-30. doi: 10.1111/j.1440-1630.2012.01005.x.
More than 50% of people do not resume driving post-stroke. Potential disincentives include limited knowledge about assessment, access to services, cost and fear of failure. Factors contributing to a successful return to driving have been the focus of limited research.
To determine the proportion of people with stroke who successfully pass their first on-road occupational therapy driving assessment, and factors associated with a successful assessment outcome.
A retrospective cohort study design was used. The primary data collection method was a review of 441 consecutive occupational therapy driving assessment reports from one Australian metropolitan centre. Participants had a diagnosis of stroke, a driving licence pre-stroke and completed a driving assessment between 1999 and 2010.
Of the 441 records analysed, the mean age of drivers was 65.4 years (SD: 15.4). The majority (53.7%) passed their first assessment (pass/conditional pass); only 8.8% failed. A weak relationship was found between initial driving assessment outcome and time post-stroke (r(s) = 0.19), but a fair relationship with younger age (r(s) = 0.31) and higher scores on three off-road assessments (r(s) = -0.26 to -0.28). The strongest predictors of initial driving assessment outcome were off-road assessment scores, age, gender and time post-stroke (R(2) = 19.7%, P < 0.01).
Data on stroke severity are required to confirm these preliminary predictors of driving assessment outcome. Stroke severity should be routinely documented by driving assessment services for use in future research.
超过50%的人中风后不再恢复驾驶。潜在的阻碍因素包括对评估、服务获取、成本以及失败恐惧的了解有限。促成成功恢复驾驶的因素一直是有限研究的重点。
确定中风患者首次通过道路职业治疗驾驶评估的比例，以及与成功评估结果相关的因素。
采用回顾性队列研究设计。主要数据收集方法是对来自澳大利亚一个大城市中心的441份连续职业治疗驾驶评估报告进行审查。参与者患有中风，中风前持有驾驶执照，并在1999年至2010年期间完成了驾驶评估。
在分析的441份记录中，驾驶员的平均年龄为65.4岁（标准差：15.4）。大多数人（53.7%）通过了首次评估（通过/有条件通过）；只有8.8%的人未通过。发现初始驾驶评估结果与中风后时间之间存在微弱关系（r(s)=0.19），但与较年轻年龄（r(s)=0.31）以及三项非道路评估的较高分数（r(s)= -0.26至-0.28）存在适度关系。初始驾驶评估结果的最强预测因素是非道路评估分数、年龄、性别和中风后时间（R(2)=19.7%，P<0.01）。
需要中风严重程度数据来证实这些驾驶评估结果的初步预测因素。驾驶评估服务应常规记录中风严重程度，以供未来研究使用。
