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功能性神经障碍患者的驾驶体验。

Lived experience of driving in individuals with functional neurological disorder.

机构信息

Department of Neurology, Alrijne Ziekenhuis, Leiderdorp, Zuid-Holland, The Netherlands.

RECOVER Injury Research Centre, The University of Queensland, Brisbane, Australia.

出版信息

Brain Behav. 2024 Aug;14(8):e3652. doi: 10.1002/brb3.3652.

Abstract

BACKGROUND

Functional neurological disorder (FND) is a common neurological diagnosis that encapsulates a range of incapacitating clinical presentations. These include functional seizures, movement disorders, and sensory disturbances. Safe driving requires both cognitive skills and physical abilities, which may be impacted by FND symptoms. The primary objective of this study was to gain deeper insights into the challenges faced by people with FND when driving.

METHODS

A qualitative study and interpretative phenomenological analysis were conducted. Individuals experiencing functional seizures and/or movement disorders completed both questionnaires and semi-structured interviews about FND symptoms, driving behavior, and crashes.

RESULTS

A total of 26 patients with FND participated in this study. Based on the interviews, four key themes were identified: (1) driving difficulties experienced by individuals with FND; (2) strategies utilized by people with FND to overcome difficulties experienced while driving; (3) barriers preventing driving challenges being addressed in this population; and (4) crashes and perceived dangerous driving events experienced by individuals with FND. All participants reported that driving a car provoked FND symptoms and this affected their driving ability. FND sufferers reported using a number of strategies such as limiting how far they drive and relying on advanced driver assistance system features to help manage their associated symptoms, such as fatigue and/or pain. Several participants reported crashes and perceived dangerous driving events since developing FND.

CONCLUSION

Individuals experiencing FND often employ self-regulation techniques, yet the extent to which these methods enhance driving safety remains uncertain. The variable nature of the disorder makes judging an individual's driving risk particularly difficult. The themes emerging from the interviews highlighted the need for further empirical research to inform guidelines and best practice when determining the impact of FND on an individual's driving safety .

摘要

背景

功能性神经障碍(FND)是一种常见的神经诊断,它包含了一系列使人丧失能力的临床表现。这些表现包括功能性癫痫发作、运动障碍和感觉障碍。安全驾驶需要认知技能和身体能力,而这些可能会受到 FND 症状的影响。本研究的主要目的是更深入地了解 FND 患者在驾驶时所面临的挑战。

方法

进行了一项定性研究和解释性现象学分析。患有功能性癫痫发作和/或运动障碍的个体完成了与 FND 症状、驾驶行为和事故有关的问卷和半结构化访谈。

结果

共有 26 名 FND 患者参与了这项研究。根据访谈,确定了四个关键主题:(1)FND 患者所经历的驾驶困难;(2)FND 患者用来克服驾驶时所经历的困难的策略;(3)阻止该人群解决驾驶挑战的障碍;(4)FND 患者所经历的事故和感知到的危险驾驶事件。所有参与者都报告说,开车会引发 FND 症状,这会影响他们的驾驶能力。FND 患者报告说使用了一些策略,例如限制驾驶的距离,并依赖先进的驾驶员辅助系统功能来帮助管理与他们相关的症状,例如疲劳和/或疼痛。一些参与者报告说,自从患上 FND 以来,他们发生了事故和感知到的危险驾驶事件。

结论

患有 FND 的个体通常会采用自我调节技术,但这些方法在多大程度上提高驾驶安全性仍不确定。该疾病的多变性质使得判断个体的驾驶风险变得特别困难。访谈中出现的主题强调需要进一步的实证研究,以便为确定 FND 对个体驾驶安全的影响提供指导方针和最佳实践。

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