Hostname: page-component-8448b6f56d-tj2md Total loading time: 0 Render date: 2024-04-18T18:49:08.368Z Has data issue: false hasContentIssue false

Attitudes: Mediators of the Relation between Health and Driving in Older Adults

Published online by Cambridge University Press:  03 June 2016

Holly Tuokko*
Affiliation:
Centre on Aging, University of Victoria
Paweena Sukhawathanakul
Affiliation:
Psychology Department, University of Victoria
Laura Walzak
Affiliation:
Psychology Department, University of Victoria
Alexandra Jouk
Affiliation:
Centre on Aging, University of Victoria
Anita Myers
Affiliation:
School of Public Health & Health Systems, University of Waterloo
Shawn Marshall
Affiliation:
Ottawa Hospital Research Institute, University of Ottawa
Gary Naglie
Affiliation:
Research Department, Toronto Rehabilitation Institute, University Health Network Department of Medicine and Rotman Research Institute, Baycrest Geriatric Health Care Centre Department of Medicine and Institute of Health Policy, Management and Evaluation, University of Toronto
Mark Rapoport
Affiliation:
Department of Psychiatry, University of Toronto
Brenda Vrkljan
Affiliation:
School of Rehabilitation Science, McMaster University
Michelle Porter
Affiliation:
Faculty of Kinesiology and Recreation Management, University of Manitoba
Malcolm Man-Son-Hing
Affiliation:
Ottawa Hospital Research Institute, University of Ottawa
Barbara Mazer
Affiliation:
School of Physical & Occupational Therapy, McGill University Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain
Nicol Korner-Bitensky
Affiliation:
School of Physical & Occupational Therapy, McGill University Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain
Isabelle Gélinas
Affiliation:
School of Physical & Occupational Therapy, McGill University Centre de Recherche Interdisciplinaire en Réadaptation du Montréal Métropolitain
Michel Bédard
Affiliation:
Centre for Research on Safe Driving, Lakehead University
*
La correspondance et les demandes de tirés-à-part doivent être adressées à: / Correspondence and requests for offprints should be sent to: Dr. Holly Tuokko Centre on Aging University of Victoria PO BOX 1700, STN CSC Victoria, BC V8W 2Y2 (htuokko@uvic.ca)

Abstract

We examined the relations between perceived health (e.g., self-perceived health status) and driving self-regulatory practices (e.g., frequency of driving, avoiding challenging driving situations) as mediated by driving attitudes and perceptions (i.e., driving comfort, positive and negative attitudes towards driving) in data collected for 928 drivers aged 70 and older enrolled in the Candrive II study. We observed that specific attitudes towards driving (e.g., driving comfort, negative attitudes towards driving) mediate the relations between health symptoms and self-regulatory driving behaviours at baseline and over time. Only negative attitudes towards driving fully mediated the relationships between changes in perceived health symptoms and changes in driving behavior. Perceived health symptoms apparently influence the likelihood of avoiding challenging driving situations through both initial negative attitudes towards driving as well as changes in negative attitudes over time. Understanding influences on self-regulatory driving behaviours will be of benefit when designing interventions to enhance the safety of older drivers.

Résumé

Nous avons examiné les relations entre la santé perçue (p. ex., l’état de santé auto-évaluation) et des pratiques d’autorégulation de la conduite (p. ex., la fréquence de la conduite, l’evitement des situations de conduite difficiles) comme médiée par les attitudes et les perceptions de conduite (à savoir, le confort de conduite, les attitudes positif et négatif envers la conduite) dans les données recueillies pour 928 conducteurs âgés de 70 ans et plus inscrits à l’étude Candrive II. Nous avons observé que les attitudes spécifiques à la conduite (p. ex., le confort de conduite, les attitudes négatives envers la conduite) assurent la médiation des relations entre les symptômes de santé et les comportements de conduite auto-reglementés au début et au fil du temps. Seuls les attitudes négatives à l’égard de conduite ont mediés entièrement les relations entre les changements dans les symptômes perçus de la santé et les changements dans le comportement de conduite. Les symptômes perçus pour la santé influencent apparemment la probabilité d’éviter des situations difficiles de conduite par le biais de deux attitudes négatives initiales pour la conduite, ainsi que des changements dans les attitudes négatives au fil du temps. Comprendre les influences sur le comportement de conduite d’auto-réglementation seront bénéfiques lors de la conception des interventions visant à améliorer la sécurité des conducteurs âgés.

Type
Articles
Copyright
Copyright © Canadian Association on Gerontology 2016 

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

American Association of Motor Vehicle Administrators. (2009). Driver fitness medical guidelines. National Traffic Safety Administration. Washington, DC: U.S. Department of Transportation.Google Scholar
Anstey, K. J., Windsor, T., Luczcz, M., & Andrews, G. (2006). Predicting driving cessation over 5 years in older adults: Psychological well-being and cognitive competence are stronger predictors than physical health. Journal of the American Geriatrics Society, 54(1), 121126.Google Scholar
Anstey, K. J., Wood, J., Lord, S., & Walker, J. (2005). Cognitive, sensory and physical factors enabling driving safety in older adults. Clinical Psychology Review, 25(1), 4565.CrossRefGoogle ScholarPubMed
Baldock, M. R., Mathias, J. L., McLean, A., & Berndt, A. (2006). Self-regulation of driving and its relationship to driving ability among older adults. Accident Analysis & Prevention, 38(5), 10381045.Google Scholar
Baron, R. M., & Kenny, D. A. (1986). The moderator–mediator variable distinction in social psychological research: Conceptual, strategic, and statistical considerations. Journal of Personality and Social Psychology, 51(6), 11731182.CrossRefGoogle ScholarPubMed
Blanchard, R. A., & Myers, A. M. (2010). Examination of driving comfort and self-regulatory practices in older adults using in-vehicle devices to assess natural driving patterns. Accident Analysis & Prevention, 42(4), 12131219.CrossRefGoogle ScholarPubMed
Blanchard, R. A., Myers, A. M., & Porter, M. M. (2010). Correspondence between self-reported and objective measures of driving exposure and patterns in older drivers. Accident Analysis & Prevention, 42(2), 523529.Google Scholar
Brabyn, J. A., Schneck, M., Lott, L., & Haegerstrom-Portnoy, G. (2005). Night driving self-restriction: Vision function and gender differences. Optometry & Vision Science, 82(8), 755764.Google Scholar
Canadian Medical Association. (2012). CMA Driver’s Guide: Determining medical fitness to operate motor vehicles (8th ed.). Toronto, ON: Author.Google Scholar
Carmel, S., Rechavi, T. B., & Ben-Moshe, Y. (2014). Antecedents of self-regulation in driving among older drivers. Ageing and Society, 34, 10971117.Google Scholar
Crizzle, A. M., Myers, A. M., & Almeida, Q. J. (2013). Self-regulatory practices of drivers with Parkinson’s disease: Accuracy of patient reports. Parkinsonism and Related Disorders, 19(2), 176180.Google Scholar
Crizzle, A. M., Myers, A. M., Roy, E. A., & Almeida, Q. J. (2013). Drivers with Parkinson’s disease: Are the symptoms of PD associated with restricted driving practices? Journal of Neurology, 260, 25622568.CrossRefGoogle ScholarPubMed
D’Ambrosio, L. A., Donorfio, L. K. M., Coughlin, J. F., Mohyde, M., & Meyer, J. (2008). Gender differences in self-regulation patterns and attitudes towards driving among older adults. Journal of Women & Aging, 20, 265282.Google Scholar
Donorfio, L., D’Ambrosio, L., Coughlin, J., & Mohyde, M. (2008). Health, safety, self-regulation and the older driver: It’s not just a matter of age. Journal of Safety Research, 39(6), 555561.Google Scholar
Donorfio, L., Mohyde, M., Coughlin, J., & D’Ambrosio, L. (2008). A qualitative exploration of self-regulation behaviors among older drivers. Journal of Aging & Social Policy, 20(3), 323339.CrossRefGoogle ScholarPubMed
Edwards, J. D., Lunsman, M., Perkins, M., Rebok, G. W., & Roth, D. L. (2009). Driving cessation and health trajectories in older adults. Journal of Gerontology: Series A: Biological and Medical Sciences, 64, 12901295.CrossRefGoogle ScholarPubMed
Gwyther, H. & Holland, C. (2012). The effect of age, gender and attitudes on self-regulation in driving. Accident Analysis & Prevention, 45, 1928.Google Scholar
Hudon, C., Fortin, M., & Vanasse, A. (2005). Cumulative illness rating scale was a reliable and valid index in the family practice context. Journal of Clinical Epidemiology, 58, 603608.CrossRefGoogle ScholarPubMed
Jouk, A., Tuokko, H., Myers, A., Marshall, S., Man-Son-Hing, M., Porter, M. M., et al. (2014). Psychosocial constructs and self-reported driving restriction in the Candrive II older adult baseline cohort. Transportation research Part F, 27, 110.CrossRefGoogle Scholar
Librero, J., Peiro, S., & Ordinana, R. (1999). Chronic comorbidity and outcomes of hospital care: Length of stay, mortality, and readmission at 30 and 365 days. Journal of Clinical Epidemiology, 52, 171179.CrossRefGoogle ScholarPubMed
Lindstrom-Forneri, W., Tuokko, H., & Rhodes, R. (2007). “Getting around town”: A preliminary investigation of the theory of planned behavior and intent to change driving behaviors among older adults. Applied Gerontology, 26(4), 385398.CrossRefGoogle Scholar
Lindstrom-Forneri, W., Tuokko, H. A., Garrett, D., & Molnar, F. (2010). Driving as an everyday competence: A model of driving competence and behavior. Clinical Gerontologist: The Journal of Aging and Mental Health, 33(4), 283297.Google Scholar
Linn, B. S., Linn, M. W., & Gurel, L. (1968). Cumulative illness rating scale. Journal of American Geriatrics Society, 16, 622626.Google Scholar
MacDonald, L., Myers, A. M., & Blanchard, R. A. (2008). Correspondence among older drivers’ perceptions, abilities, and behaviors. Topics in Geriatric Rehabilitation, 24(3), 239252.Google Scholar
Marottoli, R., Cooney, L., Wagner, R., Doucette, M., & Tinetti, M. (1994). Predictors of automobile crashes and moving violations among elderly drivers. Annals of Internal Medicine, 121(11), 842846.Google Scholar
Marshall, S. C., & Man-Son-Hing, M. (2011). Multiple chronic medical conditions and associated driving risk: A systematic review. Traffic Injury Prevention, 12(2), 142148.CrossRefGoogle ScholarPubMed
Marshall, S., Man-Son-Hing, M., Bédard, M., Charlton, J., Gagnon, S., Gélinas, I., et al. (2013). Protocol for Candrive II/Ozcandrive, a multicentre prospective older driver cohort study. Accident Analysis and Prevention, 61, 245252.Google Scholar
McGwin, G. Jr., Chapman, V., & Owsley, C. (2000). Visual risk factors for driving difficulty among older drivers. Accident Analysis & Prevention, 32(6), 735744.Google Scholar
Miller, M. D., Paradis, C. F., Houck, P. R., Mazumdar, S., Stack, J. A., Rifai, A. H., et al. (1992). Rating chronic medical illness burden in geropsychiatric practice and research: Application of the cumulative illness rating scale. Psychiatry Research, 41(3), 237248.Google Scholar
Molnar, L. J., & Eby, D. (2008). The relationship between self-regulation and driving-related abilities in older drivers: An exploratory study. Traffic Injury Prevention, 9(4), 314319.Google Scholar
Muthén, L. K., & Muthén, B. O. (2012). Mplus User’s Guide (7th ed.). Los Angeles, CA: Muthén & Muthén.Google Scholar
Myers, A. M., Paradis, J., & Blanchard, R. A. (2008). Conceptualizing and measuring confidence in older drivers: Development of the day and night driving comfort scales. Archives of Physical Medicine and Rehabilitation, 89, 630640.Google Scholar
Myers, A. M., Trang, A., & Crizzle, A. M. (2011). Naturalistic study of winter driving practices by older men and women: Examination of weather, road conditions, trip purposes and comfort. Canadian Journal on Aging, 30, 577589.Google Scholar
O’Connor, M. L., Edwards, J. D., Small, B., & Andel, R. (2011). Patterns of level and change in self-reported driving behaviors among older adults: Who self-regulates? The Journals of Gerontology Series B: Psychological Sciences and Social Sciences, 67(4), 437446.Google Scholar
O’Connor, M. L., Edwards, J. D., Waters, M. P., Hudak, E. M., & Valdés, E. G. (2013). Mediators of the association between driving cessation and mortality among older adults. Journal of Aging and Health, 25(8S), 249S269S.Google Scholar
Owsley, C., Stalvey, B., & Philips, J. (2003). The efficacy of an educational intervention in promoting self-regulation among high-risk older drivers. Accident Analysis and Prevention, 35, 393400.CrossRefGoogle ScholarPubMed
Parker, D., Macdonald, L., Sutcliffe, P., & Rabbitt, P. (2001). Confidence and the older driver. Ageing and Society, 21(02), 169182.Google Scholar
Prochaska, J. O., & Velicer, W. F. (1997). The transtheoretical model of health behavior change. American Journal of Health Promotion, 12(1), 3848.Google Scholar
Rochon, P. A., Katz, J. N., Morrow, L. A., McGlinchey-Berroth, R., Ahlquist, M., Sarkarati, M., et al. (1996). Comorbid illness is associated with survival and length of hospital stay in patients with chronic disability: A prospective comparison of three comorbidity indices. Medical Care, 34, 1093–101.CrossRefGoogle ScholarPubMed
Ruechel, S., & Mann, W. C. (2005). Self-regulation of driving by older persons. Physical and Occupational Therapy in Geriatrics, 23(2–3), 91101.Google Scholar
Stalvey, B. T., & Owsley, C. (2000). Self-perceptions and current practices of high-risk older drivers: Implications for driver safety interventions. Journal of Health Psychology, 5(4), 441456.Google Scholar
Steinfeld, E., Tomita, M., Mann, W. C., & DeGlopper, W. (1999). Use of passenger vehicles by older people with disabilities. Occupational Therapy Journal of Research, 19(3), 155186.Google Scholar
Tuokko, H., McGee, P., & Rhodes, R. E. (2006). Decisional balance and readiness to change driving behavior in older adults: A pilot study. Physical & Occupational Therapy in Geriatrics, 24(3), 112.Google Scholar
Tuokko, H., Myers, A., Jouk, A., Marshall, S., Man-Son-Hing, M., Porter, M. M., et al. (2013). Associations between age, gender, psychosocial and health characteristics in the Candrive II study cohort. Accident Analysis & Prevention, 61, 267271.Google Scholar
Tuokko, H. A., Rhodes, R. E., & Dean, R. (2007). Health conditions, health symptoms and driving difficulties in older adults. Age and Ageing, 36(4), 389394.Google Scholar
Turano, K., Munoz, B., Hassan, D., Duncan, D., Gower, E., Roche, K., et al. (2009). Poor sense of direction is associated with constricted driving space in older drivers. The Journals of Gerontology: Psychological Sciences, 64B(3), 348355.Google Scholar
Ware, J. E., & Sherbourne, C. D. (1992). The MOS 36-item short-form health survey (SF-36). I. Conceptual framework and item selection. Medical Care, 30(6), 473483.Google Scholar
Weinstein, N. D. (1988). The precaution adoption process. Health Psychology, 7(4), 355386.Google Scholar