Citation

Winter L, Moriarty HJ, Short TH. PM R 2017; 9(9): 901-909.

Affiliation

Department of Mathematics and Computer Science. John Carroll University, University Heights, OH.

Copyright

(Copyright © 2017, American Academy of Physical Medicine and Rehabilitation, Publisher Elsevier Publishing)

DOI

10.1016/j.pmrj.2017.01.007

PMID

28167305

Abstract

BACKGROUND: 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. But 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, adjusting for PTSD and years since most recent TBI.

DESIGN: Cross-sectional. SETTING: Veterans' homes PARTICIPANTS: 61 veterans of the Global Wars on Terror diagnosed with TBI, all outpatient at a VA 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, role limitations due to physical health problems and those due to emotional problems. Self-rated competence in driving was the predictor and sociodemographic characteristics, PTSD diagnosis, TBI severity, and time since most recent TBI were covariates.

RESULTS: Self-rated driving difficulty was associated with decreased community reintegration (β=.280, p =.028), greater depressive symptomatology (β= -. 402, p <.001), and greater role limitations due to physical problems (β= -.312, p =.011) and to emotional problems (β= -.324, p =.006), after adjusting 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.

Copyright © 2017 American Academy of Physical Medicine and Rehabilitation. Published by Elsevier Inc. All rights reserved.

Language: en

Keywords

Community reintegration; SF-36V; Veterans; depressive symptomatology; driving; physical functioning; role limitations; social participation; traumatic brain injury; well-being