Barriers to driving and community integration after traumatic brain injury

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Abstract:

Objective: To examine the relations among driving status, perceptions of barriers to the resumption
of driving, and community integration outcomes after traumatic brain injury (TBI). Design:
Correlational research using logistic and multiple regression analyses, analyses of variance, and
covariance. Participants: Fifty-one survivors of TBI, 6 months to 10 years postinjury. Main outcome
measures: Driving status postinjury. Community Integration Measure, and Craig Hospital
Assessment and Reporting Technique. Results: Perceptions of barriers to driving provided unique
information in predicting subjective and objective indices of community integration, even after
accounting for other potentially pertinent variables (eg, injury severity, social support, negative affectivity, and use of alternative transportation). Moreover, survivors who had not resumed driving
showed poorer community integration than did those who had resumed driving. Social barriers
such as directives against driving from significant others accounted for the most variance in survivor
driving status. Decisions to cease driving were more common among those with no formal
driving evaluation than among survivors who had been evaluated. Conclusions: Significant others
have substantial influence on post-TBI driving outcome. The findings highlight the importance of
independent driving to community integration, as well as psychoeducation of survivors and their
families.

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