An integrative review: understanding driving retirement decisions for individuals living with a dementia

Andrew, Catherine; Traynor, Victoria; Iverson, Donald C

doi:10.1111/jan.12727

Cited by 29 publications

(31 citation statements)

References 51 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Data appraisal was performed by two researchers using the Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist for qualitative studies [ 15 ] and National Health Medical Research Council (NHMRC) Appraisal Evidence Matrix for mixed methods and quantitative research [ 16 ]. Quantitative and mixed method studies were ranked as outlined by Andrew et al [ 17 ], (i.e. Excellent-A; Good-B; Satisfactory-C and Poor-4).…”

Section: Methodsmentioning

confidence: 99%

Barriers and solutions to online learning in medical education – an integrative review

et al. 2018

View full text Add to dashboard Cite

BackgroundThe aim of this study is to review the literature on known barriers and solutions that face educators when developing and implementing online learning programs for medical students and postgraduate trainees.MethodsAn integrative review was conducted over a three-month period by an inter-institutional research team. The search included ScienceDirect, Scopus, BioMedical, PubMed, Medline (EBSCO & Ovid), ERIC, LISA, EBSCO, Google Scholar, ProQuest A&I, ProQuest UK & Ireland, UL Institutional Repository (IR), UCDIR and the All Aboard Report. Search terms included online learning, medical educators, development, barriers, solutions and digital literacy. The search was carried out by two reviewers. Titles and abstracts were screened independently and reviewed with inclusion/exclusion criteria. A consensus was drawn on which articles were included. Data appraisal was performed using the Critical Appraisal Skills Programme (CASP) Qualitative Research Checklist and NHMRC Appraisal Evidence Matrix. Data extraction was completed using the Cochrane Data Extraction Form and a modified extraction tool.ResultsOf the 3101 abstracts identified from the search, ten full-text papers met the inclusion criteria. Data extraction was completed on seven papers of high methodological quality and on three lower quality papers. Findings suggest that the key barriers which affect the development and implementation of online learning in medical education include time constraints, poor technical skills, inadequate infrastructure, absence of institutional strategies and support and negative attitudes of all involved. Solutions to these include improved educator skills, incentives and reward for the time involved with development and delivery of online content, improved institutional strategies and support and positive attitude amongst all those involved in the development and delivery of online content.ConclusionThis review has identified barriers and solutions amongst medical educators to the implementation of online learning in medical education. Results can be used to inform institutional and educator practice in the development of further online learning.Electronic supplementary materialThe online version of this article (10.1186/s12909-018-1240-0) contains supplementary material, which is available to authorized users.

show abstract

Section: Methodsmentioning

confidence: 99%

Barriers and solutions to online learning in medical education – an integrative review

et al. 2018

View full text Add to dashboard Cite

show abstract

“…Many studies exist on driving in individuals with MCI and AD; however, there have been few syntheses of the literature that examine how individuals with AD, their families, and providers determine when an individual with MCI or early-stage dementia is safe or unsafe to drive. Most recently, Andrew, Traynor, and Iverson (2016) conducted an integrative review on driving decision making in individuals with dementia. Their review primarily contained sources prior to the current review (they ended their search in 2012), and focused on how individuals make decisions to stop driving.…”

Section: Review Aimmentioning

confidence: 99%

Driving in Early-Stage Alzheimer's Disease: An Integrative Review of the Literature

Davis¹,

Ohman²

2017

Research in Gerontological Nursing

View full text Add to dashboard Cite

One of the most difficult decisions for individuals with Alzheimer's disease (AD) is when to stop driving. Because driving is a fundamental activity linked to socialization, independent functioning, and well-being, making the decision to stop driving is not easy. Cognitive decline in older adults can lead to getting lost while driving, difficulty detecting and avoiding hazards, as well as increased errors while driving due to compromised judgment and difficulty in making decisions. The purpose of the current literature review was to synthesize evidence regarding how individuals with early-stage AD, their families, and providers make determinations about driving safety, interventions to increase driving safety, and methods to assist cessation and coping for individuals with early-stage AD. The evidence shows that changes in driving ability start early and progress throughout the trajectory of AD. Some individuals with mild cognitive impairment or early-stage AD may be safe to drive for a period of time. Support groups aimed at helping with the transition have been shown to be helpful for individuals who stop driving. Research and practice must support interventions to help individuals maintain safety while driving, as well as cope with driving cessation. [Res Gerontol Nurs. 2017; 10(2):86-100.].

show abstract

“…It is difficult to define when a patient with dementia is no longer fit to drive [ 13 ] because of large individual differences in the patterns of dysfunctions, related to the different aetiologies of dementia [ 14 , 15 ]. Therefore, the most appropriate moment to cease driving needs to be assessed on a case-by-case basis [ 16 ].…”

Section: Introductionmentioning

confidence: 99%

“…However, a proportion of patients with dementia continues to drive despite evidence of a decreased fitness to drive [ 20 ]. Some of these patients did not recall their fitness-to-drive assessment, others were not aware of their own cognitive impairment (due to decreased insight associated with dementia) or believed that their cognitive impairment did not affect driving safety [ 13 , 16 , 21 – 25 ]. According to the last group, the assessment process was ‘not fair’ and did not accurately reflect their fitness to drive [ 13 , 16 , 21 ].…”

Section: Introductionmentioning

confidence: 99%

“…Some of these patients did not recall their fitness-to-drive assessment, others were not aware of their own cognitive impairment (due to decreased insight associated with dementia) or believed that their cognitive impairment did not affect driving safety [ 13 , 16 , 21 – 25 ]. According to the last group, the assessment process was ‘not fair’ and did not accurately reflect their fitness to drive [ 13 , 16 , 21 ]. These findings suggest that fitness-to-drive assessments should be comprehensive, comprising several types of tasks and sources of information, and that guidance for patients with dementia in interpreting a recommendation about driving is essential [ 25 – 28 ].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Adherence to driving cessation advice given to patients with cognitive impairment and consequences for mobility

et al. 2018

View full text Add to dashboard Cite

BackgroundDriving is related to social participation; therefore older drivers may be reluctant to cease driving. Continuation of driving has also been reported in a large proportion of patients with cognitive impairment. The aim of this study is to investigate whether patients with cognitive impairment adhere to driving cessation advice after a fitness-to-drive assessment and what the consequences are with regard to mobility.MethodsPatients with cognitive impairment (n = 172) participated in a fitness-to-drive assessment study, including an on-road driving assessment. Afterwards, patients were advised to either continue driving, to follow driving lessons, or to cease driving. Approximately seven months thereafter, patients were asked in a follow-up interview about their adherence to the driving recommendation. Factors influencing driving cessation were identified using a binary logistic regression analysis. Use of alternative transportation was also evaluated.ResultsRespectively 92 and 79% of the patients adhered to the recommendation to continue or cease driving. Female gender, a higher Clinical Dementia Rating-score, perceived health decline, and driving cessation advice facilitated driving cessation. Patients who ceased driving made use of less alternative modes of transportation than patients who still drove. Nonetheless, around 40% of the patients who ceased driving increased their frequency of cycling and/or public transport use.ConclusionsAdherence to the recommendations given after the fitness-to-drive assessments was high. Female patients were in general more likely to cease driving. However, a minority of patients did not adhere to driving cessation advice. These drivers with dementia should be made aware of the progression of their cognitive impairment and general health decline to facilitate driving cessation. There are large differences in mobility between patients with cognitive impairment. Physicians should discuss options for alternative transportation in order to promote sustained safe mobility of patients with cognitive impairment.

show abstract

An integrative review: understanding driving retirement decisions for individuals living with a dementia

Cited by 29 publications

References 51 publications

Barriers and solutions to online learning in medical education – an integrative review

Barriers and solutions to online learning in medical education – an integrative review

Driving in Early-Stage Alzheimer's Disease: An Integrative Review of the Literature

Adherence to driving cessation advice given to patients with cognitive impairment and consequences for mobility

Contact Info

Product

Resources

About