Driving and Reintegration Into the Community in Patients After Stroke
Driving and Reintegration Into the Community in Patients After Stroke
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DOI：
10.1016/j.pmrj.2010.03.030
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发表时间：
2010-06-01
期刊：
影响因子：
2.1
通讯作者：
Jessup, Anita
中科院分区：
文献类型：
--
作者：
Finestone, Hillel M.;Guo, Meiqi;Jessup, Anita
目的：探讨驾驶与不驾驶与卒中后社区融合的关系。设计：前瞻性研究。地点：加拿大安大略省的六个驾驶评估中心。参与者：53名居住在社区的患者，他们在中风后被推荐进行驾驶评估。方法：通过半结构访谈收集人口统计学、生活环境、健康状况、驾驶习惯和驾车史的数据，并在3个场合进行各种问卷调查：研究条目(=中风后1个月；主要结果测量：1年后重新融入社区，用重新融入正常生活指数(RNLI)进行评估。结果：参与者在进入研究前平均持续中风12.3个月。两名受试者在研究开始时开车。在1年时，43名受试者中有28人(65%)通过了驾驶考试，并已恢复/继续驾驶。非驾驶员的RNLI平均得分显著低于驾驶员。那些在研究开始时没有开车，但在一年后恢复驾驶的受试者的RNLI得分显著增加(P=.011)。在对伴随的健康状况进行调整后，驾车与社区融合显著相关(P<；.001)。1年后驾驶和健康状况与社区融合相关，可解释RNLI得分的32%。结论：经健康状况调整后，卒中后驾驶与社区融合显著相关(P<；.001)。社区决策者可能会决定在确定中风幸存者的交通需求时使用该研究结果，这些幸存者由于天气、时间或距离的考虑而自我限制驾驶。PM R 2010；2：497-503
Objective: To investigate the relationship between driving versus not driving and community integration after stroke. Much research on patients who drive after experiencing a stroke has focused on driving assessment protocols; little attention has been given to the implications of assessment outcomes.Design: Prospective study.Setting: Six driving evaluation centers in Ontario, Canada.Participants: Fifty-three community-dwelling patients who were referred for a driving assessment after they experienced a stroke.Methods: Data on demographics, living circumstances, health status, driving habits, and driving history were gathered via a semistructured interview and various questionnaires administered on 3 occasions: study entry (>= 1 month after stroke; n = 53), 3 months (n = 44), and 1 year (n = 43).Main Outcome Measurement: Reintegration into the community at 1 year, as evaluated with the Reintegration to Normal Living Index (RNLI).Results: The participants had sustained a stroke an average of 12.3 months before study entry. Two subjects were driving at study entry. At 1 year, 28 (65%) of 43 subjects had passed their driving test and had resumed/continued driving. Nondrivers had a significantly lower mean RNLI score than drivers. Subjects who were not driving at study entry but had resumed driving by 1 year had a significant increase in RNLI score (P = .011). Driving was significantly associated with community integration after adjustment for concomitant health status (P < .001). Driving and health status were associated with community integration at 1 year, accounting for 32% of the variance in RNLI score.Conclusions: Driving after stroke was significantly associated with community integration in patients after adjustment for health status (P < .001). Community decision-makers may decide to use the study results when determining the transportation needs of stroke survivors who self-limit their driving because of weather, time of day, or distance concerns. PM R 2010;2:497-503