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Driving and Reintegration Into the Community in Patients After Stroke
Author(s) -
Finestone Hillel M.,
Guo Meiqi,
O'Hara Paddi,
GreeneFinestone Linda,
Marshall Shawn C.,
Hunt Lynn,
Biggs Jennifer,
Jessup Anita
Publication year - 2010
Publication title -
pmandr
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.617
H-Index - 66
eISSN - 1934-1563
pISSN - 1934-1482
DOI - 10.1016/j.pmrj.2010.03.030
Subject(s) - medicine , stroke (engine) , community integration , occupational safety and health , demographics , injury prevention , community health , poison control , physical therapy , human factors and ergonomics , test (biology) , gerontology , demography , emergency medicine , public health , nursing , mechanical engineering , paleontology , pathology , sociology , engineering , biology
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.