Aboalfaraj Nawaf T, Talab Rana K, Hemy Alexander R, Talab Sedrah K, Yoshida Eric M
Department of Medicine, King Abdulaziz University Hospital, Jeddah, Saudi Arabia.
Department of Medicine, University of Jeddah, Jeddah, Saudi Arabia.
Can Liver J. 2024 Dec 19;7(4):439-446. doi: 10.3138/canlivj-2024-0026. eCollection 2024 Dec.
Hepatic encephalopathy (HE) is a neuropsychiatric syndrome resulting from liver dysfunction, leading to significant cognitive and motor impairments. These impairments can severely affect daily activities, including driving. This research explores the public safety issue of HE and driving safety, focusing on the knowledge and practices of health care professionals.
An electronic survey was distributed across various institutions in British Columbia, Canada, targeting 191 health care professionals, including attending physicians, residents, nurse practitioners, medical students, and fellows from various specialties. The survey assessed the training received, frequency of discussions about driving safety, and actions taken regarding advising patients to stop driving.
This study revealed significant gaps in addressing driving safety protocols by health care providers among patients with HE. Only 19.9% of professionals routinely ask their patients about driving, and few engage in specific discussions about driving safety. Internal medicine and gastroenterology specialists, who are most likely to care for patients with HE, reported low practices of screening for and educating about HE and driving safety.
The findings underscore the need for increased awareness and proactive discussions among health care providers regarding driving safety in patients with HE. Implementing routine assessments and discussions in HE management protocols can enhance patient safety. Future research should focus on developing standardized guidelines and evaluating the effectiveness of interventions in reducing driving-related risks.
肝性脑病（HE）是一种由肝功能障碍引起的神经精神综合征，会导致严重的认知和运动障碍。这些障碍会严重影响日常活动，包括驾驶。本研究探讨了肝性脑病与驾驶安全的公共安全问题，重点关注医疗保健专业人员的知识和实践。
在加拿大不列颠哥伦比亚省的各个机构开展了一项电子调查，目标对象是191名医疗保健专业人员，包括主治医生、住院医生、执业护士、医学生以及各专业的研究员。该调查评估了所接受的培训、关于驾驶安全的讨论频率以及就建议患者停止驾驶所采取的行动。
本研究揭示了医疗保健提供者在处理肝性脑病患者驾驶安全协议方面存在重大差距。只有19.9%的专业人员会定期询问患者的驾驶情况，很少有人进行关于驾驶安全的具体讨论。最有可能照料肝性脑病患者的内科和胃肠病学专家报告称，在筛查和教育肝性脑病及驾驶安全方面的实践较少。
研究结果强调，医疗保健提供者需要提高对肝性脑病患者驾驶安全的认识并积极开展讨论。在肝性脑病管理协议中实施常规评估和讨论可以提高患者安全性。未来的研究应侧重于制定标准化指南并评估干预措施在降低与驾驶相关风险方面的有效性。
