Article

The ability to drive is a core function supporting independent
living. Traumatic brain injury (TBI) may impair driving capacity in numerous
ways. Previous research has documented that individuals with TBI have more
driving-related problems than other people and has identified predictors of
driving status or capacity, mostly among civilians; however, no research has
examined the implications of driving limitations for the well-being of
individuals with TBI. OBJECTIVE: To examine the association between self-reported
difficulty in driving with important domains of psychological well-being in
veterans with TBI, with adjustment for posttraumatic stress disorder (PTSD) and
years since most recent TBI. DESIGN: Cross-sectional. SETTING: Veterans' homes.
PARTICIPANTS: A total of 61 veterans of the Global Wars on Terrorism diagnosed
with TBI, all outpatients at a Veterans Affairs medical center rehabilitation
service. METHODS: Home interviews as a baseline assessment for a larger
randomized controlled trial. MAIN OUTCOME MEASURES: Community reintegration
(extent of social participation), depressive symptomatology, and role limitations
due to physical health problems and those due to emotional problems. Self-rated
competence in driving was the predictor, and sociodemographic characteristics,
diagnosis of PTSD, severity of TBI, and time since most recent TBI were
covariates. RESULTS: Self-rated driving difficulty was associated with decreased
community reintegration (beta = .280, P =.028), greater depressive symptomatology
(beta = -.402, P < .001), and greater role limitations due to physical problems
(beta = -.312, P =.011) and to emotional problems (beta = -.324, P = .006), after
we adjusted for PTSD and other variables. DISCUSSION: The self-reported ability
to drive seems to be central to psychological well-being in veterans with TBI,
showing clear associations with depression, community reintegration, and
health-related role limitations. These associations cannot be attributed to
comorbid PTSD. CONCLUSION: Rehabilitation specialists should view driving
difficulty as a risk factor for poor psychosocial outcomes in veterans with TBI
and seek ways to compensate for the veteran's loss of driving if it is no longer advisable.
LEVEL OF EVIDENCE: II.
CI - Copyright (c) 2017 American Academy of Physical Medicine and Rehabilitation.
Published by Elsevier Inc. All rights reserved.

Langue : ANGLAIS