title: Managing driving issues after an acquired brain injury: strategies used by health professionals.
abstract: OBJECTIVE
  The ability to drive safely can be affected by an acquired brain injury. Following acquired brain injury, clients may experience driving disruptions, formal assessment, return to driving or permanent cessation. Health professionals may be involved in formal driving or component skills' assessment and rehabilitation, or interventions for continued community participation. Meeting the needs of clients related to driving remains a challenging area of clinical practice. The aim of this study was to investigate how driving issues are currently managed by acquired brain injury rehabilitation teams.
  
  
  METHODS
  This study utilised a qualitative phenomenological approach to gain insight into the approaches undertaken by four rehabilitation teams working with clients post-acquired brain injury. Semi-structured, audiotaped interviews were conducted with 25 participants who had identified driving as part of their role.
  
  
  RESULTS
  Health professional participants described three major areas of clinical focus, describing strategies and challenges associated with each. These were as follows: 'Integrating driving goals into rehabilitation' which involved optimising timing and acknowledging the clients' focus on driving while enhancing driving and rehabilitation outcomes; 'Managing emotional responses' which required protecting therapeutic relationships and providing information, as well as responding to more extreme responses; and finally 'Managing unlicensed driving and meeting long-term needs', which participants identified as the most challenging aspect. Strategies involved using set procedures, building on knowledge of the client, supporting the family and exploring alternatives.
  
  
  CONCLUSIONS
  The teams described a range of strategies used to address the challenges related to driving and driving cessation which can be applied to successfully manage this issue in acquired brain injury rehabilitation.
authors.affiliation: UQ Centre for Clinical Research, The University of Queensland, Brisbane, Queensland, Australia.
authors.forename: Jacki
authors.initials: J
authors.lastname: Liddle
authors.forename: Rebecca
authors.initials: R
authors.lastname: Hayes
authors.forename: Louise
authors.initials: L
authors.lastname: Gustafsson
authors.forename: Jennifer
authors.initials: J
authors.lastname: Fleming
mesh_terms: D000223:Adaptation, Psychological; D000328:Adult; D000368:Aged; D001334:Automobile Driving / Q000523:psychology*; D001930:Brain Injuries / Q000523:psychology* / Q000534:rehabilitation*; D004644:Emotions; D005260:Female; D006040:Goals; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D008875:Middle Aged; D020380:Needs Assessment; D009788:Occupational Therapy / Q000458:organization & administration*; D036301:Qualitative Research; D015599:Trauma Severity Indices
keywords: ABI; driving; qualitative; rehabilitation teams