Driving poststroke: problem identification, assessment use, and interventions offered by canadian occupational therapists.
OBJECTIVE
Driving is a key factor in maintaining autonomy and participation in life. Occupational therapists (OTs) are expected to assess individuals who want to resume driving post stroke and to provide retraining where appropriate. Research from the 1980s and 1990s indicated that patients were, for the most part, not being assessed and retrained. However, little is known about current practice management. Thus, this study examined clinicians' management of driving-related issues when treating clients with stroke.


METHODS
We performed a Canadawide telephone survey of 480 OTs providing stroke rehabilitation in both inpatient rehabilitation and community-based settings. Clinicians reported on problems they noted and assessments and interventions they would provide for a "typical patient" described in a vignette that matched their work setting.


RESULTS
20% and 34% of clinicians responding to the inpatient rehabilitation and community-based vignettes, respectively, identified return to driving as a problem. Clinician and work environment variables significantly associated (P < .01) with identifying driving as a potential problem included being male, involvement in university teaching, research conducted in setting, and hosting student placements. The use of driving-specific assessments was under 12%. Less than 6% of clinicians offered driving retraining, and their desired use of retraining was low.


CONCLUSIONS
Few clinicians identified driving as a problem post stoke, raising concern that patients attempt to drive on their own or never resume driving because of a lack of attention to driving during their rehabilitation. Poststroke driver assessment and retraining is a critical component of poststroke community reintegration that requires greater awareness by clinicians.
Faculty of Medicine, School of Physical and Occupational Therapy, McGill University, Montreal, Quebec, Canada.
Anita
A
Petzold
Nicol
N
Korner-Bitensky
Annie
A
Rochette
Robert
R
Teasell
Shawn
S
Marshall
Marie-Josee
MJ
Perrier
D001334:Automobile Driving / Q000523:psychology*; D002170:Canada / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D019538:Health Care Surveys; D006282:Health Personnel / Q000523:psychology; D006801:Humans; D007062:Identification, Psychological; D008297:Male; D009788:Occupational Therapy / Q000379:methods* / Q000706:statistics & numerical data; D020521:Stroke / Q000453:epidemiology / Q000503:physiopathology*; D000071939:Stroke Rehabilitation; D011795:Surveys and Questionnaires; D000078329:Workforce