Abstract
The overall aim of this thesis was to explore and describe methods for
assessing driving ability and awareness of driving disability following
stroke, and to explore and describe the lived-experience of driving
ability in the process of a driving evaluation.
The thesis included four studies. In Study I people with stroke drove in
a driving simulator and the focus was to investigate aspects of validity
and stability of a newly developed assessment tool, PDrive, using Rasch
statistics. In Study II people with stroke who had previously conducted a
driving test in a driving simulator and had difficulties driving safely
participated. The aim was to investigate awareness of driving disability.
In Study III four men with stroke were interviewed during their driving
evaluations. The aim was to explore and describe the lived-experience of
driving ability in the context of being in the process of a driving
evaluation using a phenomenological approach. In Study IV participants
were people with stroke, dementia and mild cognitive impairments. The
participants took an on-road driving test and the aim was to determine
aspects of validity and reliability of P-Drive (on-road version), using
Rasch statistics.
In conclusion, the results of Studies I and IV indicated that P-Drive
(two new versions) was an assessment tool that was valid and reliable for
assessing driving ability in people with stroke in a driving simulator or
on-road, respectively. Both versions of P-Drive demonstrated evidence of
internal scale validity, person response validity and also acceptable
levels of person separation reliability. In Study II lack of awareness of
driving disability was evident since the majority of the drivers who
failed the simulator test also had limited awareness of their disability.
In Study III the participants experienced their driving ability as
unaffected by the onset of stroke, and driving ability was taken for
granted. Limited awareness of disability was indicated since participants
were driving despite recommendations not to drive. The results (Study
III) also increased our knowledge about the negative feelings that could
be aroused by driving cessation and evaluation.
