title: Exploring the relationship between self-awareness of driving efficacy and that of a proxy when determining fitness to drive after stroke.
abstract: OBJECTIVE
  The inclusion of a driving specific self-awareness measure may assist the clinical screening process to determine fitness to drive after stroke. This article reports on the use of the Adelaide Driving Self-Efficacy Scale (ADSES) and a proxy ADSES for completion by a significant other in assessment of fitness to drive post-stroke.
  
  
  METHODS
  A prospective study among a clinical sample of stroke patients was conducted incorporating an off-road occupational therapy assessment, an on-road assessment and a six-month follow-up. Self and proxy driver efficacy ratings were compared with each other at off-road assessment and at six-month follow-up, both ratings were compared with structured on-road ratings of driving performance.
  
  
  RESULTS
  Forty-six stroke patients (37 men), mean age 63.5 years, were recruited to the study. Thirty-five participants successfully completed the on-road test. ADSES and proxy ratings were high and a ceiling effect was noted. Self and proxy ratings were significantly correlated with each other and both correlated with the on-road assessment ratings. The ADSES ratings were sensitive to the final driving outcome with scores of the restricted driving group significantly lower than the unrestricted group. Proxy ratings showed a decrease at six-month follow-up.
  
  
  CONCLUSIONS
  The ADSES is an easy to administer tool that warrants further use in stroke rehabilitation. Scores on the ADSES differentiated between restricted and unrestricted driving recommendations post-stroke. These preliminary findings indicate its potential use as a proxy measure to assist in identifying patient who are not ready for formal driving assessment.
authors.affiliation: Department of Occupational Therapy, Trinity College Dublin, Dublin, Ireland. tadhg.stapleton@tcd.ie
authors.forename: Tadhg
authors.initials: T
authors.lastname: Stapleton
authors.forename: Deirdre
authors.initials: D
authors.lastname: Connolly
authors.forename: Desmond
authors.initials: D
authors.lastname: O'Neill
mesh_terms: D001334:Automobile Driving / Q000523:psychology* / Q000706:statistics & numerical data; D001364:Awareness; D005260:Female; D006801:Humans; D008297:Male; D016743:Mental Competency; D008875:Middle Aged; D009788:Occupational Therapy; D011446:Prospective Studies; D011594:Psychometrics; D020377:Self Efficacy; D012647:Self-Assessment; D013223:Statistics as Topic; D000071939:Stroke Rehabilitation