PDF(Pubmed)
Abstract：
BACKGROUND: Decisions about driving for individuals living with dementia (ILWD) can be challenging. There are limited evidence-based person-centred interventions in the United Kingdom that support decisions about transitioning to not driving or guidelines for developing decision aids for ILWD. This study aimed to understand the important features of a decision aid through the cultural adaptation of Australian dementia and driving decision aid (DDDA) for ILWD residing in the United Kingdom.
METHODS: This qualitative study was theoretically underpinned by a person-centred framework and conducted over three stages: (1) Development of a draft UK-specific DDDA; (2) semistructured interviews with ILWD and an online survey with stakeholders to obtain their views on a draft UK DDDA and (3) content analysis and synthesis of qualitative data to inform the final version of the decision aid.
RESULTS: Eleven ILWD and six of their spouses participated in interviews, and 102 stakeholders responded to an online survey. The four broad features identified as important to include in a decision aid for drivers living with dementia were: a structured and interactive format; positive and supportive messaging and presentation; relevant and concise content and choice-centred. The perceived benefits of the decision aid were identified as supporting conversations, enhancing collaborative decision making and enabling agency with decisions about driving and future mobility options.
CONCLUSIONS: Decision aids that are underpinned by interactive choice-driven questions enhance a person-centred approach to decisions about driving. Positively framing decision aids through the presentation and content can facilitate engagement with the decision-making process about driving. The findings have implications for the development of decision aids designed for ILWD on other important health and social topics.
UNASSIGNED: Advocating for the development of a UK DDDA were ILWD. Healthcare professionals contributed to the development of a draft UK DDDA. Former and current drivers living with dementia, family members, healthcare professionals and other support networks of ILWD participated in interviews or an online survey which informed the final version of the UK DDDA.
METHODS: This qualitative study was theoretically underpinned by a person-centred framework and conducted over three stages: (1) Development of a draft UK-specific DDDA; (2) semistructured interviews with ILWD and an online survey with stakeholders to obtain their views on a draft UK DDDA and (3) content analysis and synthesis of qualitative data to inform the final version of the decision aid.
RESULTS: Eleven ILWD and six of their spouses participated in interviews, and 102 stakeholders responded to an online survey. The four broad features identified as important to include in a decision aid for drivers living with dementia were: a structured and interactive format; positive and supportive messaging and presentation; relevant and concise content and choice-centred. The perceived benefits of the decision aid were identified as supporting conversations, enhancing collaborative decision making and enabling agency with decisions about driving and future mobility options.
CONCLUSIONS: Decision aids that are underpinned by interactive choice-driven questions enhance a person-centred approach to decisions about driving. Positively framing decision aids through the presentation and content can facilitate engagement with the decision-making process about driving. The findings have implications for the development of decision aids designed for ILWD on other important health and social topics.
UNASSIGNED: Advocating for the development of a UK DDDA were ILWD. Healthcare professionals contributed to the development of a draft UK DDDA. Former and current drivers living with dementia, family members, healthcare professionals and other support networks of ILWD participated in interviews or an online survey which informed the final version of the UK DDDA.
摘要：
背景：关于痴呆症患者（ILWD）的驾驶决策可能具有挑战性。在英国，基于证据的以人为中心的干预措施有限，这些干预措施支持过渡到不开车的决定或为ILWD制定决策辅助工具的指南。这项研究旨在通过澳大利亚痴呆症的文化适应和居住在英国的ILWD的驾驶决策辅助（DDDA）来了解决策辅助的重要特征。
方法：这项定性研究在理论上是以人为中心的框架为基础的，分为三个阶段进行：（1）制定针对英国的DDDA草案；（2）对ILWD进行半结构化访谈，并与利益相关者进行在线调查，以获取他们对英国DDDA草案的看法；（3）内容分析和定性数据综合，以提供决策辅助的最终版本。
结果：11名ILWD和6名配偶参加了访谈，102个利益相关者回答了一项在线调查。确定为痴呆症驾驶员的决策辅助工具中包含的四个重要特征是：结构化和交互式格式；积极和支持性的消息传递和演示；相关和简洁的内容以及以选择为中心。决策援助的感知利益被确定为支持对话，加强协作决策，并通过有关驾驶和未来移动选择的决策来支持代理机构。
结论：以交互式选择驱动问题为基础的决策辅助工具增强了以人为中心的驾驶决策方法。通过演示和内容积极地构建决策辅助工具可以促进参与有关驾驶的决策过程。这些发现对开发针对ILWD的其他重要健康和社会主题的决策辅助工具具有意义。
■倡导开发英国DDDA的是ILWD。医疗保健专业人员为制定英国DDDA草案做出了贡献。以前和现在患有痴呆症的司机，家庭成员,医疗保健专业人员和ILWD的其他支持网络参加了访谈或在线调查，这些访谈或调查告知了英国DDDA的最终版本。
方法：这项定性研究在理论上是以人为中心的框架为基础的，分为三个阶段进行：（1）制定针对英国的DDDA草案；（2）对ILWD进行半结构化访谈，并与利益相关者进行在线调查，以获取他们对英国DDDA草案的看法；（3）内容分析和定性数据综合，以提供决策辅助的最终版本。
结果：11名ILWD和6名配偶参加了访谈，102个利益相关者回答了一项在线调查。确定为痴呆症驾驶员的决策辅助工具中包含的四个重要特征是：结构化和交互式格式；积极和支持性的消息传递和演示；相关和简洁的内容以及以选择为中心。决策援助的感知利益被确定为支持对话，加强协作决策，并通过有关驾驶和未来移动选择的决策来支持代理机构。
结论：以交互式选择驱动问题为基础的决策辅助工具增强了以人为中心的驾驶决策方法。通过演示和内容积极地构建决策辅助工具可以促进参与有关驾驶的决策过程。这些发现对开发针对ILWD的其他重要健康和社会主题的决策辅助工具具有意义。
■倡导开发英国DDDA的是ILWD。医疗保健专业人员为制定英国DDDA草案做出了贡献。以前和现在患有痴呆症的司机，家庭成员,医疗保健专业人员和ILWD的其他支持网络参加了访谈或在线调查，这些访谈或调查告知了英国DDDA的最终版本。
