Evaluation of driving confidence in post-stroke older drivers in South Australia

Driving Rehabilitation for Stroke Patients: A Systematic Review with Meta-Analysis

Driving enables stroke survivors to freely participate in social integration. The purpose of this review was to summarize the evidence for the therapeutic effects of driving rehabilitation for patients when they return to driving after stroke and evaluate the predictors of returning to driving to identify the factors impacting their driving rehabilitation. This study employed a systematic review and meta-analysis. PubMed and four other databases were searched until 31 December 2022. Our review included randomized controlled trials (RCT) and non-RCTs that investigated driving rehabilitation for stroke and observational studies. A total of 16 studies (two non-RCT and 14 non-RCT) were reviewed; two RCTs investigated the effect of driving rehabilitation with a simulator system, and eight and six non-RCTS evaluated the predictive factors of driving return post-stroke and compared the effects of driving rehabilitation for stroke, respectively. The National Institute of Health Stroke Scale (NIHSS) and Mini Mental State Examination (MMSE) scores and having paid employment were significant predictors of resuming driving after stroke. The results suggest that NIHSS, MMSE, and paid employment are predictors of returning to driving post-stroke. Future research should investigate the effect of driving rehabilitation on the resumption of driving in patients with stroke.

Self-Efficacy to Drive While Intoxicated: Insights into the Persistence of Alcohol-Impaired Driving

BACKGROUND

Scant research has examined event-level risk factors for impaired driving in natural drinking settings. This study assessed driving self-efficacy among intoxicated individuals to better understand decision-making about alcohol-impaired driving at night after exiting on-premise drinking establishments.

METHODS

Interview and breath test data were collected from bar patrons (n = 512) exiting 2 college bar districts in Florida and Texas.

RESULTS

Results from a multivariable linear regression model indicated that self-efficacy to drive while intoxicated was more strongly associated with situational variables, that is, perceived drunkenness and self-estimated blood alcohol concentration than patron traits, that is, past-year history of drinking, risk proneness, and sex. A large proportion of bar patrons, particularly men, expressed confidence in their ability to drive, despite being highly intoxicated. Moreover, the majority of legally intoxicated patrons who were confident in their ability to drive were aware of their high level of intoxication.

CONCLUSIONS

Emphasis should be placed on the enactment and enforcement of policies and laws to prevent alcohol-impaired driving.