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Determining fitness to drive: A systematic review of the methods and assessments used after mild traumatic brain injury / Ann Baker in The British Journal of Occupational Therapy, Volume 78 numéro 2 (Fébrier 2015)  

Public ISBD [article]  inThe British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 73-83 Titre : Determining fitness to drive: A systematic review of the methods and assessments used after mild traumatic brain injury Type de document : texte imprimé Auteurs : Ann Baker, Auteur ; Carolyn Unsworth, Auteur ; Natasha A. Lannin, Auteur Année de publication : 2015 Article en page(s) : p. 73-83 Langues : Anglais (eng) Mots-clés : Driving  Driver assessment  Fitness to drive  Mild traumatic brain injury Résumé : Introduction Limited evidence is available to support knowledge of the time-frame and capacity for fitness to drive after mild traumatic brain injury. The aim of this systematic review was to identify what methods and assessments are, or could be used to determine fitness to drive for this population. Method We undertook a systematic search of six electronic databases. Two authors rated all studies for methodological content and quality, and standardised data were extracted. Narrative analysis was conducted to understand the content of eligible studies. Findings A total of 2022 articles were retrieved; seven articles met the inclusion criteria. Self-reported questionnaires, non-standardised assessments, questionnaires completed by next-of-kin, and simulator tests were the primary methods used to determine fitness to drive. Only one assessment has been used to aid recommendations about fitness to drive in the acute hospital setting. Six additional standardised assessments were identified that have the potential to predict fitness to drive in this population group; however, these assessments require further psychometric testing prior to use. Conclusion While a variety of methods and assessments are currently used, there is little research evidence to suggest when individuals are able to return to driving after mild traumatic brain injury. Research is urgently required to determine a consistent and standardised approach to assessing fitness to drive following mild traumatic brain injury. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35926 [article] Determining fitness to drive: A systematic review of the methods and assessments used after mild traumatic brain injury [texte imprimé] / Ann Baker, Auteur ; Carolyn Unsworth, Auteur ; Natasha A. Lannin, Auteur . - 2015 . - p. 73-83. Langues : Anglais (eng) in The British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 73-83 Mots-clés : Driving  Driver assessment  Fitness to drive  Mild traumatic brain injury Résumé : Introduction Limited evidence is available to support knowledge of the time-frame and capacity for fitness to drive after mild traumatic brain injury. The aim of this systematic review was to identify what methods and assessments are, or could be used to determine fitness to drive for this population. Method We undertook a systematic search of six electronic databases. Two authors rated all studies for methodological content and quality, and standardised data were extracted. Narrative analysis was conducted to understand the content of eligible studies. Findings A total of 2022 articles were retrieved; seven articles met the inclusion criteria. Self-reported questionnaires, non-standardised assessments, questionnaires completed by next-of-kin, and simulator tests were the primary methods used to determine fitness to drive. Only one assessment has been used to aid recommendations about fitness to drive in the acute hospital setting. Six additional standardised assessments were identified that have the potential to predict fitness to drive in this population group; however, these assessments require further psychometric testing prior to use. Conclusion While a variety of methods and assessments are currently used, there is little research evidence to suggest when individuals are able to return to driving after mild traumatic brain injury. Research is urgently required to determine a consistent and standardised approach to assessing fitness to drive following mild traumatic brain injury. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35926

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Driving with homonymous visual field loss: Does visual search performance predict hazard detection? / Matthew Smith in The British Journal of Occupational Therapy, Volume 78 numéro 2 (Fébrier 2015)  

Public ISBD [article]  inThe British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 85-95 Titre : Driving with homonymous visual field loss: Does visual search performance predict hazard detection? Type de document : texte imprimé Auteurs : Matthew Smith, Auteur ; Callum D. Mole, Auteur ; Georgios K. Kountouriotis, Auteur Année de publication : 2015 Article en page(s) : p. 85-95 Langues : Anglais (eng) Mots-clés : Stroke  Hemianopia  Driving  Visual field  Visual search  Hazard detection  Reaction times  Compensation Résumé : Introduction Stroke often causes homonymous visual field loss, which can lead to exclusion from driving. Retention of a driving licence is sometimes possible by completing an on-road assessment, but this is not practical for all. It is important to find simple tests that can inform the assessment and rehabilitation of driving-related visual-motor function. Method We developed novel computerised assessments: visual search; simple reaction and decision reaction to appearing pedestrians; and pedestrian detection during simulated driving. We tested 12 patients with stroke (seven left, five right field loss) and 12 controls. Results The homonymous visual field defect group was split into adequately compensated or inadequately compensated groups based on visual search performance. The inadequately compensated group had problems with stimuli in their affected field: they tended to react more slowly than controls and in the driving task they failed to detect a number of pedestrians. In contrast, the adequately compensated group were better at detecting pedestrians, though reaction times were slightly slower than controls. Conclusion We suggest that our search task can predict, to a limited extent, whether a person with stroke compensates for visual field loss, and may potentially identify suitability for specific rehabilitation to promote return to driving. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35927 [article] Driving with homonymous visual field loss: Does visual search performance predict hazard detection? [texte imprimé] / Matthew Smith, Auteur ; Callum D. Mole, Auteur ; Georgios K. Kountouriotis, Auteur . - 2015 . - p. 85-95. Langues : Anglais (eng) in The British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 85-95 Mots-clés : Stroke  Hemianopia  Driving  Visual field  Visual search  Hazard detection  Reaction times  Compensation Résumé : Introduction Stroke often causes homonymous visual field loss, which can lead to exclusion from driving. Retention of a driving licence is sometimes possible by completing an on-road assessment, but this is not practical for all. It is important to find simple tests that can inform the assessment and rehabilitation of driving-related visual-motor function. Method We developed novel computerised assessments: visual search; simple reaction and decision reaction to appearing pedestrians; and pedestrian detection during simulated driving. We tested 12 patients with stroke (seven left, five right field loss) and 12 controls. Results The homonymous visual field defect group was split into adequately compensated or inadequately compensated groups based on visual search performance. The inadequately compensated group had problems with stimuli in their affected field: they tended to react more slowly than controls and in the driving task they failed to detect a number of pedestrians. In contrast, the adequately compensated group were better at detecting pedestrians, though reaction times were slightly slower than controls. Conclusion We suggest that our search task can predict, to a limited extent, whether a person with stroke compensates for visual field loss, and may potentially identify suitability for specific rehabilitation to promote return to driving. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35927

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A new approach to the assessment of cognition in drivers: Applying the multiple errands test for use in a simple parking exercise / Sarah Lanceley in The British Journal of Occupational Therapy, Volume 78 numéro 2 (Fébrier 2015)  

Public ISBD [article]  inThe British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 96-99 Titre : A new approach to the assessment of cognition in drivers: Applying the multiple errands test for use in a simple parking exercise Type de document : texte imprimé Auteurs : Sarah Lanceley, Auteur Année de publication : 2015 Article en page(s) : p. 96-99 Langues : Anglais (eng) Mots-clés : Driving assessment  Cognitive assessment Résumé : Statement of context: The assessment of fitness to drive can often involve cognitive screening carried out by an occupational therapist. In the field of driving assessment there is a challenge to select and administer suitable office-based cognitive tests, in conjunction with an on-road assessment, which can be used to provide supporting evidence of a client’s fitness to drive. Critical reflection on practice: This practice analysis aims to reflect on the inherent problems of office-based testing. Implications for practice: The author describes the development of a cognitive test based on the Multiple Errands Test - Hospital Version, which can be used while driving in a real-life situation. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35928 [article] A new approach to the assessment of cognition in drivers: Applying the multiple errands test for use in a simple parking exercise [texte imprimé] / Sarah Lanceley, Auteur . - 2015 . - p. 96-99. Langues : Anglais (eng) in The British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 96-99 Mots-clés : Driving assessment  Cognitive assessment Résumé : Statement of context: The assessment of fitness to drive can often involve cognitive screening carried out by an occupational therapist. In the field of driving assessment there is a challenge to select and administer suitable office-based cognitive tests, in conjunction with an on-road assessment, which can be used to provide supporting evidence of a client’s fitness to drive. Critical reflection on practice: This practice analysis aims to reflect on the inherent problems of office-based testing. Implications for practice: The author describes the development of a cognitive test based on the Multiple Errands Test - Hospital Version, which can be used while driving in a real-life situation. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35928

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Predictive validity of the Montreal Cognitive Assessment (MoCA) as a screening tool for on-road driving performance / Jade Chiu Wai Kwok in The British Journal of Occupational Therapy, Volume 78 numéro 2 (Fébrier 2015)  

Public ISBD [article]  inThe British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 100-108 Titre : Predictive validity of the Montreal Cognitive Assessment (MoCA) as a screening tool for on-road driving performance Titre original : Jade Chiu Wai Kwok, Isabelle Gélinas, Dana Benoit Type de document : texte imprimé Auteurs : Jade Chiu Wai Kwok, Auteur ; Isabelle Gélinas, Auteur ; Dana Benoit, Auteur Année de publication : 2015 Article en page(s) : p. 100-108 Langues : Anglais (eng) Mots-clés : Driving  Montreal Cognitive Assessment  Screening Résumé : Introduction The objectives of this study are to determine (1) the ability of the Montreal Cognitive Assessment to predict on-road driving performance in drivers with a neurological condition and elderly drivers with suspected cognitive decline, and (2) the association between the performance on the Useful Field of View and the performance on the Montreal Cognitive Assessment. Method This study used a retrospective design. Clients were included who had completed the Montreal Cognitive Assessment and the on-road driving evaluation from November 2006 to May 2009 (n = 154) in a driving rehabilitation program in the Montreal Area. Total scores on the Montreal Cognitive Assessment, Useful Field of View risk categories, pass or fail outcomes from an on-road evaluation, as well as demographic and clinical characteristics were recorded from participants’ medical charts. Results The Montreal Cognitive Assessment was found to have a sensitivity of 84.5% and a specificity of 50% with a cut-off of ≤25. It was significantly associated with the Useful Field of View risk category. Conclusion The Montreal Cognitive Assessment could be a valuable screening tool. However, its predictive validity is not strong enough to recommend its use as the sole instrument for identifying unfit drivers. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35929 [article] Predictive validity of the Montreal Cognitive Assessment (MoCA) as a screening tool for on-road driving performance = Jade Chiu Wai Kwok, Isabelle Gélinas, Dana Benoit [texte imprimé] / Jade Chiu Wai Kwok, Auteur ; Isabelle Gélinas, Auteur ; Dana Benoit, Auteur . - 2015 . - p. 100-108. Langues : Anglais (eng) in The British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 100-108 Mots-clés : Driving  Montreal Cognitive Assessment  Screening Résumé : Introduction The objectives of this study are to determine (1) the ability of the Montreal Cognitive Assessment to predict on-road driving performance in drivers with a neurological condition and elderly drivers with suspected cognitive decline, and (2) the association between the performance on the Useful Field of View and the performance on the Montreal Cognitive Assessment. Method This study used a retrospective design. Clients were included who had completed the Montreal Cognitive Assessment and the on-road driving evaluation from November 2006 to May 2009 (n = 154) in a driving rehabilitation program in the Montreal Area. Total scores on the Montreal Cognitive Assessment, Useful Field of View risk categories, pass or fail outcomes from an on-road evaluation, as well as demographic and clinical characteristics were recorded from participants’ medical charts. Results The Montreal Cognitive Assessment was found to have a sensitivity of 84.5% and a specificity of 50% with a cut-off of ≤25. It was significantly associated with the Useful Field of View risk category. Conclusion The Montreal Cognitive Assessment could be a valuable screening tool. However, its predictive validity is not strong enough to recommend its use as the sole instrument for identifying unfit drivers. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35929

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Using Social Judgment Theory method to examine how experienced occupational therapy driver assessors use information to make fitness-to-drive recommendations / Carolyn Unsworth in The British Journal of Occupational Therapy, Volume 78 numéro 2 (Fébrier 2015)  

Public ISBD [article]  inThe British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 109-120 Titre : Using Social Judgment Theory method to examine how experienced occupational therapy driver assessors use information to make fitness-to-drive recommendations Type de document : texte imprimé Auteurs : Carolyn Unsworth, Auteur ; Priscilla Harries, Auteur ; Miranda Davies, Auteur Année de publication : 2015 Article en page(s) : p. 109-120 Langues : Anglais (eng) Mots-clés : Automobile driving  Decision-making  Cue use  Driver assessment Résumé : Introduction As people with a range of disabilities strive to increase their community mobility, occupational therapy driver assessors are increasingly required to make complex recommendations regarding fitness-to-drive. However, very little is known about how therapists use information to make decisions. The aim of this study was to model how experienced occupational therapy driver assessors weight and combine information when making fitness-to-drive recommendations and establish their level of decision agreement. Method Using Social Judgment Theory method, this study examined how 45 experienced occupational therapy driver assessors from the UK, Australia and New Zealand made fitness-to-drive recommendations for a series of 64 case scenarios. Participants completed the task on a dedicated website, and data were analysed using discriminant function analysis and an intraclass correlation coefficient. Results Accounting for 87% of the variance, the cues central to the fitness-to-drive recommendations made by assessors are the client’s physical skills, cognitive and perceptual skills, road law craft skills, vehicle handling skills and the number of driving instructor interventions. Agreement (consensus) between fitness-to-drive recommendations was very high: intraclass correlation coefficient = .97, 95% confidence interval .96–.98). Conclusion Findings can be used by both experienced and novice driver assessors to reflect on and strengthen the fitness-to-drive recommendations made to clients. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35930 [article] Using Social Judgment Theory method to examine how experienced occupational therapy driver assessors use information to make fitness-to-drive recommendations [texte imprimé] / Carolyn Unsworth, Auteur ; Priscilla Harries, Auteur ; Miranda Davies, Auteur . - 2015 . - p. 109-120. Langues : Anglais (eng) in The British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 109-120 Mots-clés : Automobile driving  Decision-making  Cue use  Driver assessment Résumé : Introduction As people with a range of disabilities strive to increase their community mobility, occupational therapy driver assessors are increasingly required to make complex recommendations regarding fitness-to-drive. However, very little is known about how therapists use information to make decisions. The aim of this study was to model how experienced occupational therapy driver assessors weight and combine information when making fitness-to-drive recommendations and establish their level of decision agreement. Method Using Social Judgment Theory method, this study examined how 45 experienced occupational therapy driver assessors from the UK, Australia and New Zealand made fitness-to-drive recommendations for a series of 64 case scenarios. Participants completed the task on a dedicated website, and data were analysed using discriminant function analysis and an intraclass correlation coefficient. Results Accounting for 87% of the variance, the cues central to the fitness-to-drive recommendations made by assessors are the client’s physical skills, cognitive and perceptual skills, road law craft skills, vehicle handling skills and the number of driving instructor interventions. Agreement (consensus) between fitness-to-drive recommendations was very high: intraclass correlation coefficient = .97, 95% confidence interval .96–.98). Conclusion Findings can be used by both experienced and novice driver assessors to reflect on and strengthen the fitness-to-drive recommendations made to clients. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35930

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On-road driving assessment and route design for drivers with dementia / Angela H. Berndt in The British Journal of Occupational Therapy, Volume 78 numéro 2 (Fébrier 2015)  

Public ISBD [article]  inThe British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 121-130 Titre : On-road driving assessment and route design for drivers with dementia Type de document : texte imprimé Auteurs : Angela H. Berndt, Auteur ; Esther May, Auteur ; Peteris Darzins, Auteur Année de publication : 2015 Article en page(s) : p. 121-130 Langues : Anglais (eng) Mots-clés : Dementia  Driving  On-road assessment  Route design Résumé : Introduction Dementia causes the progressive loss of cognitive capacities and thus impairs social and daily living skills. Dementia, to varying degrees, influences driver performance and safety. Eventually drivers affected by dementia must stop driving so they do not harm themselves or others. However, having to stop driving can result in loss of mobility and social connections. Therefore, assessing drivers with dementia is important. Driving assessment is susceptible to possible biases, including unreliable driving performance measures or driving routes that are inconsistent in the levels of difficulty of the driving tasks and manoeuvres. The aim of the study was to determine what measures of driving performance could optimally be applied to occupational therapy on-road driving assessments. Method All drivers with dementia underwent a 60 minute, set route on-road driving assessment that consisted of 110 pre-programmed observation points. Results The study identified 80 sufficiently challenging driving tasks and described the relationship of driving error to that task, for example, critical errors at unguided intersections. Conclusion The results of the task-demand by error type analysis identified a list of task items that can be applied to assessment route design to increase consistency of on-road assessment for people with dementia. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35931 [article] On-road driving assessment and route design for drivers with dementia [texte imprimé] / Angela H. Berndt, Auteur ; Esther May, Auteur ; Peteris Darzins, Auteur . - 2015 . - p. 121-130. Langues : Anglais (eng) in The British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 121-130 Mots-clés : Dementia  Driving  On-road assessment  Route design Résumé : Introduction Dementia causes the progressive loss of cognitive capacities and thus impairs social and daily living skills. Dementia, to varying degrees, influences driver performance and safety. Eventually drivers affected by dementia must stop driving so they do not harm themselves or others. However, having to stop driving can result in loss of mobility and social connections. Therefore, assessing drivers with dementia is important. Driving assessment is susceptible to possible biases, including unreliable driving performance measures or driving routes that are inconsistent in the levels of difficulty of the driving tasks and manoeuvres. The aim of the study was to determine what measures of driving performance could optimally be applied to occupational therapy on-road driving assessments. Method All drivers with dementia underwent a 60 minute, set route on-road driving assessment that consisted of 110 pre-programmed observation points. Results The study identified 80 sufficiently challenging driving tasks and described the relationship of driving error to that task, for example, critical errors at unguided intersections. Conclusion The results of the task-demand by error type analysis identified a list of task items that can be applied to assessment route design to increase consistency of on-road assessment for people with dementia. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35931

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Reliability of P-drive in occupational therapy following a short training session: A promising instrument measuring seniors’ on-road driving competencies / Paul Vaucher in The British Journal of Occupational Therapy, Volume 78 numéro 2 (Fébrier 2015)  

Public ISBD [article]  inThe British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 131-139 Titre : Reliability of P-drive in occupational therapy following a short training session: A promising instrument measuring seniors’ on-road driving competencies Type de document : texte imprimé Auteurs : Paul Vaucher, Auteur ; Cyndia Di Biase, Auteur ; Emma Lobsiger, Auteur Année de publication : 2015 Article en page(s) : p. 131-139 Langues : Anglais (eng) Mots-clés : Ageing  Mild cognitive impairment  Automobile driving  On-road evaluation  Reliability Résumé : Introduction Occupational therapists could play an important role in facilitating driving cessation for ageing drivers. This, however, requires an easy-to-learn, standardised on-road evaluation method. This study therefore investigates whether use of ‘P-drive’ could be reliably taught to occupational therapists via a short half-day training session. Method Using the English 26-item version of P-drive, two occupational therapists evaluated the driving ability of 24 home-dwelling drivers aged 70 years or over on a standardised on-road route. Experienced driving instructors’ on-road, subjective evaluations were then compared with P-drive scores. Results Following a short half-day training session, P-drive was shown to have almost perfect between-rater reliability (ICC2,1 = 0.950, 95% CI 0.889 to 0.978). Reliability was stable across sessions including the training phase even if occupational therapists seemed to become slightly less severe in their ratings with experience. P-drive’s score was related to the driving instructors’ subjective evaluations of driving skills in a non-linear manner (R 2 = 0.445, p = 0.021). Conclusion P-drive is a reliable instrument that can easily be taught to occupational therapists and implemented as a way of standardising the on-road driving test. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35932 [article] Reliability of P-drive in occupational therapy following a short training session: A promising instrument measuring seniors’ on-road driving competencies [texte imprimé] / Paul Vaucher, Auteur ; Cyndia Di Biase, Auteur ; Emma Lobsiger, Auteur . - 2015 . - p. 131-139. Langues : Anglais (eng) in The British Journal of Occupational Therapy > Volume 78 numéro 2 (Fébrier 2015) . - p. 131-139 Mots-clés : Ageing  Mild cognitive impairment  Automobile driving  On-road evaluation  Reliability Résumé : Introduction Occupational therapists could play an important role in facilitating driving cessation for ageing drivers. This, however, requires an easy-to-learn, standardised on-road evaluation method. This study therefore investigates whether use of ‘P-drive’ could be reliably taught to occupational therapists via a short half-day training session. Method Using the English 26-item version of P-drive, two occupational therapists evaluated the driving ability of 24 home-dwelling drivers aged 70 years or over on a standardised on-road route. Experienced driving instructors’ on-road, subjective evaluations were then compared with P-drive scores. Results Following a short half-day training session, P-drive was shown to have almost perfect between-rater reliability (ICC2,1 = 0.950, 95% CI 0.889 to 0.978). Reliability was stable across sessions including the training phase even if occupational therapists seemed to become slightly less severe in their ratings with experience. P-drive’s score was related to the driving instructors’ subjective evaluations of driving skills in a non-linear manner (R 2 = 0.445, p = 0.021). Conclusion P-drive is a reliable instrument that can easily be taught to occupational therapists and implemented as a way of standardising the on-road driving test. En ligne : http://bjo.sagepub.com/content/78/2.toc Permalink : ./index.php?lvl=notice_display&id=35932

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