Associations between self and informant ratings of executive functioning and driver behaviour following acquired brain injury
Per-Ola Rike, Line Aksdal Eriksen, Anne-Kristine Schanke
Department of Research, Sunnaas Rehabilitation Hospital, NO-1450 Nesoddtangen, Norway. E-mail: firstname.lastname@example.org
Objectives: To investigate self and informant ratings of everyday executive functions and their correlation with driving behaviour after acquired brain injury.
Methods: A 1-year follow-up study of 24 adults with stroke and 10 adults with traumatic brain injury deemed fit to drive after a multidisciplinary driving assessment. Baseline measures included neuropsychological tests and self and informant reports of everyday executive function (Behavior Rating of Executive Function; BRIEF-A). Follow-up measurements were the Swedish Driver Behaviour Questionnaire (DBQ) and Sunnaas Driving Pattern Questionnaire (SDPQ).
Results: Patients’ ratings on the BRIEF-A were significantly associated with the DBQ at follow-up, whereas informants’ ratings were not. Neither patients’ nor informants’ reports were associated with accident involvement or the use of compensatory driving strategies. No significant associations were found between level of awareness and driving parameters.
Conclusion: Patients’ reports of everyday executive functioning were more strongly associated with driving behaviour than were informants’ reports. Future studies are warranted to explore how informant and patient reports can contribute to distinguishing safe from unsafe drivers among patient groups with impaired awareness of deficits.
Not all survivors of stroke or traumatic brain injury resume driving, due to sensory, motor and cognitive deficits. In general, in other studies of brain-injured drivers, caregivers’ perceptions of patients’ driving-related capacities have been shown to be strong predictors of driving behaviour in daily life. However, this study found that patients, rather than caregivers’, perceptions of driving fitness, were most strongly related to driving behaviour, such as driving mistakes and inattention. We conclude that it is important to consider patients’ own perceptions of their driving-related functions when assessing fitness to drive after a brain injury.
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