OCCUPATIONAL THERAPY IN HEALTH CARE最新文献

Decisions related to driving safety and when to cease driving are complex and costly. There is an interest in developing an off-road driving test utilizing neuropsychological tests that could help assess fitness-to-drive. Serial trichotomization has demonstrated potential as it yields 100% sensitivity and specificity in retrospective test samples. The purpose of this study was to test serial trichotomization using four common neuropsychological tests (Trail Making Test Part A and B, Clock Drawing Test, and Modified Mini-Mental State Examination). Test scores from 105 patients who were seen in a memory clinic were abstracted. After applying the model, participants were classified as unfit, fit, or requiring further testing, 38.1%, 25.8%, and 36.1%, respectively. This study provides further evidence that trichotomization can facilitate the assessment of fitness-to-drive.

Occupational therapists are in a unique position to screen and evaluate fitness to drive with both visual-motor processing speed and reaction time being important factors to consider when determining fitness to drive. This study uses the Vision Coach^TM to investigate the differences in visual-motor processing speed and reaction time across age and sex of healthy adults. It also explores whether the position of sitting or standing made any difference. The results showed no difference between male/female or standing/sitting positions. However, there was a statistically significant difference between age groups, with older adults demonstrating slower visual-motor processing speed and reaction times. These findings can be used for future studies to explore the impact of injury or disease on visual-motor processing speed and reaction times and its relation to fitness to drive.

This study aimed to establish inter-rater reliability among three raters while training new driver rehabilitation specialists to correctly identify driving errors on a DriveSafety 250 driving simulator. Five participants completed adaptation, residential and suburban, and city and highway scenarios. Intraclass correlation coefficients indicated scores between .623-.877 (p = .003-.122) for the total driving errors recorded in the two scenario drives with rater agreement initially ranging between 7-8%. When analyzing the data for types of driving errors, the intraclass correlation coefficients ranged from .556-.973 (p < .05) and rater agreement between 15-100%. Through proper training and strategy development, raters reached 100% consensus on all aspects of inter-rater reliability while assessing driving errors.

Ceasing driving is associated with many negative outcomes. We examined the perceived impact of driving cessation among current older drivers. Transcripts from 92 interviews with participants from several locations across Canada were analyzed using inductive thematic analysis. We identified five themes: planning for mobility change, mobility supports and neighborhoods, financial security, fearing loss of control and independence, and coping and acceptance as a part of aging. Findings highlight diverse attitudes toward driving cessation, ranging from avoidance to acceptance, and emphasize the importance of tailored resources for drivers at various stages of behavior change.

This cross-sectional study compared visual-motor processing speed and reaction times between medically-at-risk drivers and normal controls to determine if the time in seconds distinguished between drivers who pass, fail, or need restrictions based on a road test. The medically-at-risk drivers' data (N = 35, 28-89 years) were collected as part of a comprehensive driving evaluation and coded by diagnosis (e.g., cognitive, neurological, medical) and driving outcome. The healthy control (N = 121, 21-79 years) data were collected in previous studies. The Vision Coach™ Full Field 60 task was used to collect reaction times in seconds between the two groups. Independent t-tests showed a significant difference (p < .001) in trial times between healthy controls and medically-at-risk adults. No significant difference (p = .141) was found between the three diagnoses groups. The resulting scores from the Vision Coach™ demonstrated a significant different (p < .001) between those who were determined fit to drive without restrictions and those who were determined not fit to drive after a comprehensive driving evaluation, showing the potential to be used as a screening tool for determining driving risk.

Novice drivers show poorer performance than experienced drivers in terms of visual skills and hazard perception. This study aimed at evaluating the effectiveness of a digital game-based intervention on hazard perception and visual skills in novice drivers. Forty-six novice drivers (6 men, 40 women) were randomized to the intervention group (n = 23; 20.79 ± 0.81 years) or control (n = 23; 20.65 ± 0.93 years) group. The intervention group received a game-based intervention in addition to a hazard perception training, whereas the control group received only the hazard perception training. Hazard perception and visual skills were assessed in both groups before and after the 14-day interventions. Between-group comparisons revealed significantly greater improvements in visual short time memory, visual closure, visual discrimination, figure-ground and total scores in the game-based group than in the control group (p < 0.05 for all). Our results showed that 14 days of game-based intervention enhanced hazard perception and visual skills in novice drivers. Using game-based interventions in driving rehabilitation is recommended to improve hazard perception and visual skills of novice drivers.

This study explored the effect of music on the driving performance of experienced young adult drivers with and without autism spectrum disorder (ASD) using an interactive driving simulator with two types of scenarios. A 2 (Group: autism/neurotypical) × 2 (Music: music/no music) × 2 (Scenario: hazards/wayfinding) factorial design was used with the order of scenarios and music conditions counterbalanced. Participants were 34 neurotypical drivers and 5 drivers with ASD, all with at least 3 years of driving experience. Paired sample t-tests demonstrated no effect of music for any condition. Overall, the drivers with ASD had higher performance means than the neurotypical group with significant differences in the wayfinding scenario and the category for following regulations. Neurotypical drivers had better performance on the wayfinding scenario than the hazard scenario in maneuvers and being attentive to the environment. Although this study had a low number of drivers with ASD, it suggests drivers with ASD can perform better than neurotypical drivers, possibly because they follow road rule guidelines more consistently than neurotypical peers. In addition, this is the first study to examine wayfinding skills in teens/young adults with and without ASD.

This scoping review utilized the JBI methodology to investigate methods of goal-setting used in the rehabilitation of adults with physical dysfunctions. Electronic databases were searched for articles published in the last 5 years. The inclusion of articles and data extraction were performed by two independent reviewers. Results were presented and synthesized numerically and thematically analyzed. Results suggest that goals should be client-centered and specific and long-term goals, should be complemented with medium and short-term goals. While various goal-setting methods are used in current practice, their full potential is often not realized due to improper implementation. Therefore, there is a need for educating clinicians to improve the goal-setting process and ensure its effectiveness.