Elgar Nathan J, Esterman Adrian J, Antic Nick A, Smith Brian J
Respiratory Medicine Unit, The Queen Elizabeth Hospital, Woodville South, South Australia, Australia.
School of Nursing and Midwifery, University of South Australia, Adelaide, South Australia, Australia.
J Clin Sleep Med. 2016 Mar;12(3):293-9. doi: 10.5664/jcsm.5568.
Health professionals are frequently required to report to relevant authorities all drivers who are potentially unsafe due to medical conditions. We aimed to assess both the effect of mandatory reporting (MR) on patient self-predicted behavior and what factors might encourage unsafe drivers to self-report to these authorities.
We included 5 questions in the South Australian Health Omnibus Survey, an annual, community based, face-to-face survey. We asked (1) how subjects would behave towards their doctor in light of MR if they believed their licences were at risk due to a medical condition; and (2) which factor(s) would cause them to self-report to the same authorities.
Responses to 3,007 surveys (response rate 68.5%, age 15-98) showed that 9.0% would avoid diagnosis, lie to their doctor, or doctor shop in order to keep their licence; 30.8% were unaware of the legislated requirement to self-report; and 37.9% were unaware of potentially jeopardizing insurance support if they failed to comply. If educated in these 2 areas, warned about the dangers of driving against medical advice and instructed to do so by their doctor, then 95.8% of people would self-report to the authorities, a number significantly higher than could be reported by their doctors (91.0%).
MR causes 9.0% of people to predict to behave towards their doctor in a manner that reduces road safety. With education and encouragement to do so, more people will self-report to the authorities than could be reported by their doctors via the MR pathway.
A commentary on this article appears in this issue on page 287.
卫生专业人员经常被要求向相关当局报告所有由于健康状况而可能不安全的驾驶员。我们旨在评估强制报告（MR）对患者自我预测行为的影响，以及哪些因素可能促使不安全驾驶员向这些当局自我报告。
我们在南澳大利亚综合健康调查中纳入了5个问题，这是一项基于社区的年度面对面调查。我们询问：（1）如果受试者认为由于健康状况其驾照面临风险，鉴于强制报告，他们会如何对待自己的医生；（2）哪些因素会促使他们向同一当局自我报告。
对3007份调查问卷的回复（回复率68.5%，年龄15 - 98岁）显示，9.0%的人会为了保留驾照而避免诊断、向医生说谎或去其他诊所就医；30.8%的人不知道有自我报告的法律要求；37.9%的人不知道如果不遵守规定可能会危及保险支持。如果在这两个方面得到教育，被警告不听从医嘱驾驶的危险，并得到医生的指示，那么95.8%的人会向当局自我报告，这一数字显著高于医生能够报告的人数（91.0%）。
强制报告导致9.0%的人预测会以降低道路安全的方式对待他们的医生。通过教育和鼓励，向当局自我报告的人数将超过医生通过强制报告途径能够报告的人数。
关于本文的一篇评论发表在本期第287页。
