Driving Transitions and Mental Health in Disabled Elders

描述(由申请人提供)：大多数先前关于驾驶和老龄化的研究都集中在与停止驾驶有关的人口统计学和医学因素上。然而，关于驾驶过渡的心理社会影响，后续心理健康问题的严重性或轨迹，或者为什么一些老年人比其他人更有能力以更少的心理痛苦完成这些过渡，人们知之甚少。对于越来越多的视力有问题的老年人来说，驾驶决策尤其重要。拟议的纵向研究的主要目的是研究从司机到前司机的过渡对有视力问题的老年司机来说可能或多或少是困难的，这取决于他们的个人、社会和背景资源。从概念上讲，这项研究借鉴了最近的健康行为改变模型，该模型考察了一个人愿意并能够改变健康行为的条件(例如，驾驶自我调节和停止)。这项拟议的研究将通过使用前瞻性和理论指导的方法来扩展先前关于晚年驾驶的研究。这项研究的具体目的是：1.确定驾驶自律的程度和停止驾驶的发生情况，并研究它们对视障老年人的心理健康结果(即抑郁、特定视力的心理健康、心理健康)的短期和长期影响。2.考察个人资源(例如，个人目标结构、自我调节应对倾向)、社会资源(例如，家庭、朋友和专业人员的影响)和背景资源(例如，替代交通工具)对有关驾驶自我调节和随时间推移停止驾驶的决策的影响。3.确定关键的个人、社会和背景资源，同时和随着时间的推移，调解驾驶自我调节和戒烟对心理健康结果的影响。4.探讨参与者和被调查者在驾驶行为报告和决策互动中的一致性程度，以及一致性对停止驾驶和心理健康结果的影响。参与者将是从社区视力康复机构招募的380名老年司机(55岁以上)。数据将通过在基线和1年和2年的跟踪调查中的面对面访谈，以及在4、8、16和20个月的简短的季度电话采访来收集。此外，还将与举报人(家人或朋友)进行基线和为期一年和两年的电话面谈。分析将使用回归、个人成长和结构方程建模技术解决并发关联(横截面)和预期关系(纵向)。

DESCRIPTION (provided by applicant): Most prior research in driving and aging has focused on demographic and medical factors associated with driving cessation. However, little is known about the psychosocial influences on driving transitions, the severity or trajectory of subsequent mental health problems, or why some older adults are better able than others to make these transitions with less psychological distress. Driving decisions are especially salient for the growing numbers of older adults with vision problems. The primary aim of the proposed longitudinal study is to examine how the transition from driver to ex-driver may be more or less difficult for older drivers with vision problems, depending on their personal, social, and contextual resources. Conceptually, the study draws upon recent health behavior change models that examine the conditions under which a person is willing and able to change a health behavior (e.g., driving self-regulation and cessation). The proposed study will extend prior research on driving in later life by using a prospective and theoretically guided approach. Specific aims of the proposed research are: 1. To identify the extent of driving self-regulation and the occurrence of driving cessation, and to examine both their short- and long-term impact on mental health outcomes (i.e., depression, vision-specific mental health, psychological well-being) among visually impaired older adults. 2. To examine the influence of personal resources (e.g., personal goal structures, self-regulatory coping tendencies), social resources (e.g., influence of family, friends and professionals) and contextual resources (e.g., alternative transportation) on decisions regarding driving self regulation and cessation over time. 3. To identify the key personal, social and contextual resources that, concurrently and over time, mediate the impact of driving self-regulation and cessation on mental health outcomes. 4. To explore the extent to which participants and informants are congruent in reports of driving behaviors and interactions regarding decision-making, and to explore the influence of congruence on driving cessation and mental health outcomes. Participants will be 380 older adult drivers (age 55+) recruited from a community-based vision rehabilitation agency. Data will be collected through in-person interviews at baseline and at 1- and 2-year follow-ups, as well as brief quarterly telephone interviews at 4, 8, 16, and 20 months. In addition, baseline and 1- and 2-year telephone interviews with an informant (family or friend) will be conducted. Analyses will address concurrent associations (cross sectional) and prospective relationships (longitudinal) using Regression-, Individual Growth-, and Structural Equation Modeling techniques.