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Lagrand TJ, van der Hoeven I, Vaezipour A, Palmer DDG, Hill A, Horswill MS, Lehn AC. Lived experience of driving in individuals with functional neurological disorder. Brain Behav 2024; 14:e3652. [PMID: 39169457 PMCID: PMC11338837 DOI: 10.1002/brb3.3652] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2024] [Revised: 07/07/2024] [Accepted: 08/08/2024] [Indexed: 08/23/2024] Open
Abstract
BACKGROUND Functional neurological disorder (FND) is a common neurological diagnosis that encapsulates a range of incapacitating clinical presentations. These include functional seizures, movement disorders, and sensory disturbances. Safe driving requires both cognitive skills and physical abilities, which may be impacted by FND symptoms. The primary objective of this study was to gain deeper insights into the challenges faced by people with FND when driving. METHODS A qualitative study and interpretative phenomenological analysis were conducted. Individuals experiencing functional seizures and/or movement disorders completed both questionnaires and semi-structured interviews about FND symptoms, driving behavior, and crashes. RESULTS A total of 26 patients with FND participated in this study. Based on the interviews, four key themes were identified: (1) driving difficulties experienced by individuals with FND; (2) strategies utilized by people with FND to overcome difficulties experienced while driving; (3) barriers preventing driving challenges being addressed in this population; and (4) crashes and perceived dangerous driving events experienced by individuals with FND. All participants reported that driving a car provoked FND symptoms and this affected their driving ability. FND sufferers reported using a number of strategies such as limiting how far they drive and relying on advanced driver assistance system features to help manage their associated symptoms, such as fatigue and/or pain. Several participants reported crashes and perceived dangerous driving events since developing FND. CONCLUSION Individuals experiencing FND often employ self-regulation techniques, yet the extent to which these methods enhance driving safety remains uncertain. The variable nature of the disorder makes judging an individual's driving risk particularly difficult. The themes emerging from the interviews highlighted the need for further empirical research to inform guidelines and best practice when determining the impact of FND on an individual's driving safety .
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Affiliation(s)
- Tjerk J. Lagrand
- Department of NeurologyAlrijne ZiekenhuisLeiderdorpZuid‐HollandThe Netherlands
| | - Iris van der Hoeven
- Department of NeurologyAlrijne ZiekenhuisLeiderdorpZuid‐HollandThe Netherlands
| | - Atiyeh Vaezipour
- RECOVER Injury Research CentreThe University of QueenslandBrisbaneAustralia
| | - David D. G. Palmer
- Department of NeurologyPrincess Alexandra HospitalWoolloongabbaQueenslandAustralia
| | - Andrew Hill
- Minerals Industry Safety and Health Centre, Sustainable Minerals InstituteThe University of QueenslandBrisbaneAustralia
- School of PsychologyThe University of QueenslandBrisbaneAustralia
| | - Mark S. Horswill
- School of PsychologyThe University of QueenslandBrisbaneAustralia
| | - Alexander C. Lehn
- Department of NeurologyPrincess Alexandra HospitalWoolloongabbaQueenslandAustralia
- Faculty of Health, School of Biomedical SciencesQueensland University of TechnologyBrisbaneAustralia
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Lin CY, Shibata A, Ishii K, Koohsari MJ, Hadgraft N, Dunstan DW, Owen N, Oka K. Reallocating desk workers' sitting time to standing or stepping: associations with work performance. Occup Med (Lond) 2023; 73:575-580. [PMID: 38104251 PMCID: PMC10824261 DOI: 10.1093/occmed/kqad142] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2023] Open
Abstract
BACKGROUND Studies have suggested that sitting time at work may lead to underperformance but they may underestimate the benefits to desk workers' performance of reducing occupational sitting time without considering the relative effects of the specific activities replaced. AIMS To estimate differences in work performance (presenteeism, absenteeism and engagement) when occupational sitting time is reallocated to standing/stepping in desk workers. METHODS Data for middle-aged desk workers were from a Japan-wide online survey (n = 2228). Self-report proportion of occupational sitting and standing/stepping, work hours and work performance indicators, including absolute (ratings relating only to self) and relative (ratings of self, compared to others) presenteeism and absenteeism, and dimensions of work engagement, were collected. Partition and isotemporal substitution models were used to investigate the associations of occupational sitting and standing/stepping time with work performance, including their reallocation effects. RESULTS In partition models, longer occupational sitting time was associated with a lower absolute presenteeism score (i.e. less productivity), lower absolute absenteeism (i.e. longer-than-expected work hours), and lower engagement. Longer occupational standing/stepping time was associated with lower absolute absenteeism and more engagement. Isotemporal substitution models showed that each hour of occupational sitting reallocated to standing/stepping was favourably associated with overall work engagement (B = 0.087; 95% confidence interval 0.051, 0.122) and its dimensions (B ranged from 0.078 to 0.092), but was not associated with presenteeism or absenteeism. CONCLUSIONS These findings suggest that management support and practical initiatives to encourage desk workers to replace portions of their sitting time with standing/stepping may contribute to enhanced work engagement.
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Affiliation(s)
- C-Y Lin
- Department of Public Health, College of Public Health, China Medical University, Taichung, 406040Taiwan
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, 3122Australia
| | - A Shibata
- Institute of Health and Sport Sciences, University of Tsukuba, Tsukuba, 305-8577Japan
| | - K Ishii
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
| | - M J Koohsari
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
- School of Knowledge Science, Japan Advanced Institute of Science and Technology, Nomi, 923-1292Japan
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3216Australia
| | - N Hadgraft
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, 3122Australia
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, 3004Australia
| | - D W Dunstan
- Institute for Physical Activity and Nutrition, School of Exercise and Nutrition Sciences, Deakin University, Geelong, Victoria, 3216Australia
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, 3004Australia
| | - N Owen
- Centre for Urban Transitions, Swinburne University of Technology, Melbourne, Victoria, 3122Australia
- Physical Activity Laboratory, Baker Heart & Diabetes Institute, Melbourne, Victoria, 3004Australia
| | - K Oka
- Faculty of Sport Sciences, Waseda University, Tokorozawa, 359-1192Japan
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Andrews NE, Ireland D, Vijayakumar P, Burvill L, Hay E, Westerman D, Rose T, Schlumpf M, Strong J, Claus A. Acceptability of a Pain History Assessment and Education Chatbot (Dolores) Across Age Groups in Populations With Chronic Pain: Development and Pilot Testing. JMIR Form Res 2023; 7:e47267. [PMID: 37801342 PMCID: PMC10589833 DOI: 10.2196/47267] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2023] [Revised: 08/28/2023] [Accepted: 08/28/2023] [Indexed: 10/07/2023] Open
Abstract
BACKGROUND The delivery of education on pain neuroscience and the evidence for different treatment approaches has become a key component of contemporary persistent pain management. Chatbots, or more formally conversation agents, are increasingly being used in health care settings due to their versatility in providing interactive and individualized approaches to both capture and deliver information. Research focused on the acceptability of diverse chatbot formats can assist in developing a better understanding of the educational needs of target populations. OBJECTIVE This study aims to detail the development and initial pilot testing of a multimodality pain education chatbot (Dolores) that can be used across different age groups and investigate whether acceptability and feedback were comparable across age groups following pilot testing. METHODS Following an initial design phase involving software engineers (n=2) and expert clinicians (n=6), a total of 60 individuals with chronic pain who attended an outpatient clinic at 1 of 2 pain centers in Australia were recruited for pilot testing. The 60 individuals consisted of 20 (33%) adolescents (aged 10-18 years), 20 (33%) young adults (aged 19-35 years), and 20 (33%) adults (aged >35 years) with persistent pain. Participants spent 20 to 30 minutes completing interactive chatbot activities that enabled the Dolores app to gather a pain history and provide education about pain and pain treatments. After the chatbot activities, participants completed a custom-made feedback questionnaire measuring the acceptability constructs pertaining to health education chatbots. To determine the effect of age group on the acceptability ratings and feedback provided, a series of binomial logistic regression models and cumulative odds ordinal logistic regression models with proportional odds were generated. RESULTS Overall, acceptability was high for the following constructs: engagement, perceived value, usability, accuracy, responsiveness, adoption intention, esthetics, and overall quality. The effect of age group on all acceptability ratings was small and not statistically significant. An analysis of open-ended question responses revealed that major frustrations with the app were related to Dolores' speech, which was explored further through a comparative analysis. With respect to providing negative feedback about Dolores' speech, a logistic regression model showed that the effect of age group was statistically significant (χ22=11.7; P=.003) and explained 27.1% of the variance (Nagelkerke R2). Adults and young adults were less likely to comment on Dolores' speech compared with adolescent participants (odds ratio 0.20, 95% CI 0.05-0.84 and odds ratio 0.05, 95% CI 0.01-0.43, respectively). Comments were related to both speech rate (too slow) and quality (unpleasant and robotic). CONCLUSIONS This study provides support for the acceptability of pain history and education chatbots across different age groups. Chatbot acceptability for adolescent cohorts may be improved by enabling the self-selection of speech characteristics such as rate and personable tone.
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Affiliation(s)
- Nicole Emma Andrews
- RECOVER Injury Research Centre, The University of Queensland, Herston, Australia
- Tess Cramond Pain and Research Centre, The Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Australia
- The Occupational Therapy Department, The Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Australia
- Surgical Treatment and Rehabilitation Service (STARS) Education and Research Alliance, The University of Queensland and Metro North Health, Herston, Australia
| | - David Ireland
- Australian eHealth Research Centre, The Commonwealth Scientific and Industrial Research Organisation, Herston, Australia
| | - Pranavie Vijayakumar
- Australian eHealth Research Centre, The Commonwealth Scientific and Industrial Research Organisation, Herston, Australia
- The Walter and Eliza Hall Institute of Medical Research, Melbourne, Victoria, Australia
| | - Lyza Burvill
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Elizabeth Hay
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Daria Westerman
- Queensland Interdisciplinary Paediatric Persistent Pain Service, Queensland Children's Hospital, South Brisbane, Australia
| | - Tanya Rose
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Mikaela Schlumpf
- Queensland Interdisciplinary Paediatric Persistent Pain Service, Queensland Children's Hospital, South Brisbane, Australia
| | - Jenny Strong
- Tess Cramond Pain and Research Centre, The Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Australia
- The Occupational Therapy Department, The Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
| | - Andrew Claus
- Tess Cramond Pain and Research Centre, The Royal Brisbane and Women's Hospital, Metro North Hospital and Health Service, Herston, Australia
- School of Health and Rehabilitation Sciences, The University of Queensland, St Lucia, Australia
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Lagrand TJ, Vaezipour A, Hill A, Horswill MS, Lehn AC. Hazard Perception Skill and Driver Behavior in Patients With Functional Neurologic Disorders. Neurology 2023; 100:e1248-e1256. [PMID: 36539297 PMCID: PMC10033169 DOI: 10.1212/wnl.0000000000206757] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2022] [Accepted: 11/16/2022] [Indexed: 12/24/2022] Open
Abstract
BACKGROUND AND OBJECTIVES Driving in patients with functional neurologic disorders (FND) is a major concern, but current guidelines (where they exist) are based on expert consensus only due to a lack of relevant empirical evidence. This study aimed to provide such evidence by comparing drivers with FND with healthy controls on aspects of driving performance and behavior important to crash risk, including hazard perception skill. METHODS Participants completed validated self-report questionnaires of driving behaviors (assessing lapses, errors, violations, and attentional issues) and 2 computer-based measures of hazard perception skill (both known to be associated with crash risk). RESULTS We compared 43 patients who experience dissociative attacks or functional motor symptoms and 43 healthy controls. Patients with FND self-reported significantly more driving lapses and driving errors compared with healthy controls. However, there were no significant between-group differences in self-reports of ordinary violations, aggressive violations, or attention-related errors. Participants in the FND group and healthy controls exhibited a similar performance on a response time hazard perception test (6.27 vs 5.51 seconds, p = 0.245). However, participants with FND remarkably outperformed the controls in the number of plausible predictions they made in a verbal response hazard prediction test (1.55 vs 1.18 predictions per clip, p = 0.006). DISCUSSION Our findings suggest that the ability of drivers with FND to predict traffic hazards in between attacks or flares is not worse than that of healthy individuals, with the possibility that it might even be better under some circumstances. Further studies with various populations are needed to replicate our findings.
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Affiliation(s)
- Tjerk J Lagrand
- From the Department of Neurology (T.J.L., A.C.L.), Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia; RECOVER Injury Research Centre (A.V.), The University of Queensland, Brisbane, Australia., Minerals Industry Safety and Health Centre, Sustainable Minerals Institute (A.H.), The University of Queensland, Brisbane, Australia; School of Psychology (A.H., M.S.H.), The University of Queensland, Brisbane, Australia., and School of Medicine (A.C.L.), The University of Queensland, Brisbane, Australia.
| | - Atiyeh Vaezipour
- From the Department of Neurology (T.J.L., A.C.L.), Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia; RECOVER Injury Research Centre (A.V.), The University of Queensland, Brisbane, Australia., Minerals Industry Safety and Health Centre, Sustainable Minerals Institute (A.H.), The University of Queensland, Brisbane, Australia; School of Psychology (A.H., M.S.H.), The University of Queensland, Brisbane, Australia., and School of Medicine (A.C.L.), The University of Queensland, Brisbane, Australia
| | - Andrew Hill
- From the Department of Neurology (T.J.L., A.C.L.), Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia; RECOVER Injury Research Centre (A.V.), The University of Queensland, Brisbane, Australia., Minerals Industry Safety and Health Centre, Sustainable Minerals Institute (A.H.), The University of Queensland, Brisbane, Australia; School of Psychology (A.H., M.S.H.), The University of Queensland, Brisbane, Australia., and School of Medicine (A.C.L.), The University of Queensland, Brisbane, Australia
| | - Mark S Horswill
- From the Department of Neurology (T.J.L., A.C.L.), Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia; RECOVER Injury Research Centre (A.V.), The University of Queensland, Brisbane, Australia., Minerals Industry Safety and Health Centre, Sustainable Minerals Institute (A.H.), The University of Queensland, Brisbane, Australia; School of Psychology (A.H., M.S.H.), The University of Queensland, Brisbane, Australia., and School of Medicine (A.C.L.), The University of Queensland, Brisbane, Australia
| | - Alexander C Lehn
- From the Department of Neurology (T.J.L., A.C.L.), Princess Alexandra Hospital, Woolloongabba, Brisbane, Queensland, Australia; RECOVER Injury Research Centre (A.V.), The University of Queensland, Brisbane, Australia., Minerals Industry Safety and Health Centre, Sustainable Minerals Institute (A.H.), The University of Queensland, Brisbane, Australia; School of Psychology (A.H., M.S.H.), The University of Queensland, Brisbane, Australia., and School of Medicine (A.C.L.), The University of Queensland, Brisbane, Australia
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Vaezipour A, Horswill MS, Andrews NE, Johnston V, Delhomme P, Oviedo-Trespalacios O. How distracting is chronic pain? The impact of chronic pain on driving behaviour and hazard perception. ACCIDENT; ANALYSIS AND PREVENTION 2022; 178:106856. [PMID: 36228423 DOI: 10.1016/j.aap.2022.106856] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2022] [Revised: 09/22/2022] [Accepted: 09/26/2022] [Indexed: 06/16/2023]
Abstract
In road safety research, few studies have examined driving behaviour in chronic pain cohorts. The aim of this study was to investigate driving behaviour among drivers experiencing chronic pain. We compared individuals with chronic pain with age-gender matched healthy controls. Participants completed: (i) an anonymous online survey that included participant demographics, transport characteristics, self-reported driving behaviour, and pain characteristics (ii) a response-time hazard perception test and a verbal-response hazard prediction test for drivers, and (iii) a driving diary in which participants recorded their driving over two weeks. The results showed that participants with chronic pain were not significantly worse than controls for hazard perception and prediction test scores, self-reported attention-related errors, driving errors, driving violations, and involuntary distraction. Drivers with chronic pain did report significantly more driving lapses but this effect became non-significant when variables confounded with chronic pain, such as fatigue, were adjusted for. We also found that participants who reported particularly high levels of chronic pain performed worse in the hazard prediction test compared to the control group (and this effect could not be accounted for by other variables associated with chronic pain). In addition, participants with chronic pain reported significantly higher driving workload (mental demand, physical demand, effort, and frustration) compared with controls. The findings of this study provide new insights into driving behaviour in individuals with chronic pain and recommendations for future research in terms of driving assessment and self-regulation strategies are provided.
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Affiliation(s)
- Atiyeh Vaezipour
- RECOVER Injury Research Centre, The University of Queensland, Australia. https://recover.centre.uq.edu.au
| | - Mark S Horswill
- School of Psychology, The University of Queensland, Australia
| | - Nicole E Andrews
- RECOVER Injury Research Centre, The University of Queensland, Australia; Tess Cramond Pain and Research Centre, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia; Occupational Therapy Department, The Royal Brisbane and Women's Hospital, Herston, Queensland, Australia
| | - Venerina Johnston
- RECOVER Injury Research Centre, The University of Queensland, Australia
| | - Patricia Delhomme
- Univ Gustave Eiffel, Université Paris Cité, LaPEA, Versailles, France
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