Kimlin Janessa A, Black Alex A, Djaja Ngadiman, Wood Joanne M
School of Optometry and Vision Science, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
School of Public Health, Institute of Health and Biomedical Innovation, Queensland University of Technology, Brisbane, Australia.
Ophthalmic Physiol Opt. 2016 Jul;36(4):465-76. doi: 10.1111/opo.12307.
Night-time driving difficulties are a common concern of older drivers and those with eye disease. This study aimed to develop and validate a questionnaire for assessing vision-related night driving difficulties in older drivers.
Items from existing vision-related quality of life questionnaires and driving studies were used to develop a questionnaire that was completed by 283 participants who reported visual difficulties for night driving (65% female, 50 to >80 years). The questionnaire included items relating to demographic and night driving characteristics (seven items), general vision ratings (eight items), vision-related night driving difficulties (11 items), and a single open question about specific night driving difficulties. The vision-related night driving difficulty items were analysed separately using Rasch analysis to form the vision and night driving questionnaire (VND-Q). Rasch analysis assessed validity and psychometric properties of the scale. Generalised linear regression models examined associations between VND-Q scores and age, gender, amount of night driving, self-rated vision, and eye conditions. Test-retest repeatability was assessed using intra-class correlation analysis and Bland-Altman methods of agreement for a subset of 30 participants.
Rasch analysis indicated that a nine-item VND-Q scale was unidimensional, valid and reliable, and showed excellent discriminant ability (person separation index 3.04; person reliability 0.90). Targeting was better for those with greater self-reported night driving difficulties. Participants with self-reported bilateral eye conditions and worse self-reported general vision ratings had significantly more night driving difficulties with the VND-Q scale than individuals without eye conditions (p = 0.03) and with better general vision ratings (p < 0.001). Females reported more difficulties than males (p < 0.001) and drove shorter distances at night per week which was also associated with greater difficulties (p < 0.001). A repeatability coefficient (Rc ) of 2.07 demonstrated excellent test-retest repeatability.
The nine-item VND-Q is a unidimensional and reliable questionnaire allowing quantification of the level of visual difficulties that older drivers report at night. The development of this questionnaire is an important step in providing a reliable and validated instrument for use to guide appropriate investigations, referrals, or interventions in clinical and research settings.
夜间驾驶困难是老年驾驶者和患有眼疾者共同关注的问题。本研究旨在开发并验证一份用于评估老年驾驶者与视力相关夜间驾驶困难的问卷。
从现有的与视力相关的生活质量问卷和驾驶研究中选取条目，开发出一份问卷，由283名报告存在夜间驾驶视力困难的参与者填写（65%为女性，年龄在50至80岁以上）。问卷包括与人口统计学和夜间驾驶特征相关的条目（7项）、一般视力评分（8项）、与视力相关的夜间驾驶困难（11项），以及一个关于特定夜间驾驶困难的开放性问题。使用拉施分析分别对与视力相关的夜间驾驶困难条目进行分析，以形成视力与夜间驾驶问卷（VND-Q）。拉施分析评估了该量表的效度和心理测量特性。广义线性回归模型检验了VND-Q得分与年龄、性别、夜间驾驶量、自评视力和眼部状况之间的关联。对30名参与者的子集，使用组内相关分析和布兰德-奥特曼一致性方法评估重测重复性。
拉施分析表明，九项VND-Q量表是单维的、有效且可靠的，具有出色的区分能力（人员分离指数3.04；人员可靠性0.90）。对于自我报告夜间驾驶困难较大的人，靶向性更好。自我报告有双侧眼部状况且自评一般视力评分较差的参与者，使用VND-Q量表评估出的夜间驾驶困难显著多于没有眼部状况的个体（p = 0.03）以及自评一般视力评分较好的个体（p < 0.001）。女性报告的困难多于男性（p < 0.001），且女性每周夜间驾驶的距离较短，这也与更多困难相关（p < 0.001）。重测系数（Rc）为2.07，表明具有出色的重测重复性。
九项VND-Q是一份单维且可靠的问卷，能够量化老年驾驶者报告的夜间视力困难程度。这份问卷的开发是朝着提供一份可靠且经过验证的工具迈出的重要一步，该工具可用于指导临床和研究环境中的适当调查、转诊或干预。
