失智症病人停止駕駛與其心理健康初探

Driving Cessation and Mental Health in Persons With Dementia: A Preliminary Study

背景：失智症安全駕駛是全球公共衛生關心的主要議題，駕駛與個人自主性、自尊及獨立性有密切相關，一旦失去駕駛權利，則可能產生心理健康的負面效應。目的：本研究目的旨在探討停止駕駛與失智症病人心理健康之關係。方法：研究為橫斷式描述性研究，採方便取樣，使用問卷調查法，研究對象為北部某準醫學中心之失智症個案。結果：本研究共收案78位失智症病人，研究結果發現有41％之失智症病人仍在駕駛，最常使用交通工具為機車，停止駕駛者通常年齡較大、無配偶者較多、沒參與社交活動居多、日常生活功能較差，以及自覺駕駛對生活品質的重要程度較低。失智症病人停止駕駛之相關因子為年齡及工具性日常生活功能；停止駕駛者之憂鬱及焦慮程度較高，但未達統計差異。結論／實務應用：由本研究結果可知停止駕駛之失智症病人的憂鬱與焦慮程度較高，建議未來研究可以進行長期追踪研究，以了解停止駕駛之失智病人的心理健康變化及預測因子；安全駕駛議題應納入公共衛生教育，並制定失智症之安全駕駛規範。

Background: The driving safety of persons with dementia (PwD) is an important public-health issue worldwide. Driving is closely related to personal autonomy, self-esteem, and independence. When PwD lose their driving privileges, this may lead to negative effects on mental health. Purpose: The purpose of this study was to evaluate the relationship between driving cessation and mental health in PwD. Methods: A cross-sectional design with convenient sampling was used, Data were collected using structured questionnaires. Participants were all PwDs who were recruited from a medical center in northern Taiwan. Results: A total of 78 PwD were recruited. Two-fifths (41%) of the participants were still driving, with motorcycle the most common vehicle used. The participants who had retired from driving were older, and most did not have a spouse, were less socially active, had a lower mean level of functional ability, and perceived a lower association between driving and quality of life. Driving cessation was found to be positively correlated with age and the instrumental activities of daily living. Depression and anxiety levels in former drivers were higher than in current drivers, although the differences were not significant. Conclusions/ Implications for Practice: Among PwD, depression and anxiety is higher in former drivers. It is suggested that a prospective study should be conducted, that driving safety issues for PwD should be addressed in public health education, and that standards of driving safety for PwD should be developed and enacted.