Exploring the relationship between self-awareness of driving efficacy and that of a proxy when determining fitness to drive after stroke

Aust Occup Ther J. 2012 Feb;59(1):63-70. doi: 10.1111/j.1440-1630.2011.00980.x. Epub 2011 Dec 28.


Background/aim: 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.

Method: 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.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Automobile Driving / psychology*
  • Automobile Driving / statistics & numerical data
  • Awareness*
  • Female
  • Humans
  • Male
  • Mental Competency*
  • Middle Aged
  • Occupational Therapy*
  • Prospective Studies
  • Psychometrics
  • Self Efficacy
  • Self-Assessment*
  • Statistics as Topic
  • Stroke Rehabilitation*