Knowledge and attitudes of occupational therapists to giving advice on fitness to drive

Abstract

Introduction: A range of medical conditions can affect driving, and health professionals should advise patients accordingly. This study examined the knowledge of occupational therapists, other therapists and psychologists regarding medical standards for driving, their attitudes to advising patients about driving, and barriers to giving that advice. Method: A structured questionnaire measured knowledge of medical standards and attitudes to advising patients about driving. Analyses compared responses of occupational therapists with those of other therapists and psychologists. Semi-structured interviews were carried out with therapists and psychologists after they had watched a video-taped clinical consultation with an actor-patient who was unfit to drive. Interviewees, unaware that the study was about driving, were asked how they would advise the patient. Focus groups were held with a range of health professionals to discuss facilitators and barriers to giving driving advice. Results: Eighty-two questionnaires were completed. Occupational therapists were most aware of driving guidelines and most likely to advise patients to stop driving (p < 0.01). A total of 98% of occupational therapists believed they should discuss driving compared with 68% of other therapists and psychologists (p < 0.01). Therapists were more likely than psychologists to spontaneously raise the issue of driving after viewing the video-consultation. Conclusion: Occupational therapists are well placed to expand their role in advising patients about fitness to drive. For this they require additional training and clarification of their role and legal responsibilities.

Further examinations of mobility in later life and improving health and wellbeing

“…Older drivers on the whole would welcome more involvement of healthcare professionals, especially primary care doctors (General Practitioners, GPs) and opticians in deciding whether they are safe enough to continue driving (Berry 2011;Coughlan et al 2004;Musselwhite Accepted for publication in Journal of Transport & Health Available at http://www.sciencedirect.com/science/article/pii/S2214140515000250 and Shergold 2013). However, healthcare professionals, are, on the whole, reluctant to be involved and very few give advice on driving cessation (Berry 2011;Hawley 2010;Musselwhite and Shergold 2013). In Ireland, GPs assess medical fitness to drive.…”

An international study of the quality of national-level guidelines on driving with medical illness

“…Additionally, medical conditions account only for a minority of causes of crashes internationally, 29 and clinicians are wary of unfairly restricting their patients' driving because of negative impacts on their autonomy, independent functioning and on the doctor-patient relationship. 27,28,[30][31][32] Studies have been published that show clinicians are interested and willing to learn and adopt guidelines with measurable changes in practice behaviour, knowledge, confidence and attitudes. 33 Creating better processes and methodology to build better guidelines is important, but these efforts fall short unless there is adequate infrastructure and financial support to inform and educate clinicians on the use of these tools, addressing the barriers to their application.…”

Driving in stroke survivors aged 18–65 years: The Psychosocial Outcomes In StrokE (POISE) Cohort Study

“…Acute stroke is a common medical condition which can restrict one’s ability to resume driving due to cognitive, visual, or motor disability. 1,2 Most people consider driving an important aspect of independent living required to fulfill roles at home and work, and for social, financial, and psychological necessity. 3 Stroke rates have risen by 25% in those aged between 20 and 64 years, such that they now account for one third of the global burden of this disease.…”

“…1,7,8 This may reflect a low level of awareness of current driving guidelines among health professionals, 9,10 or avoidance of giving advice. 1,11 Irrespective of the advice given, there is evidence indicating that people self-regulate their driving according to how they perceive their fitness to drive, 7,12 with those experiencing an acute stroke over-estimating their ability to drive. 12 Most people are able to resume driving in the first year after stroke, 13–15 but the timing of this varies.…”