多職種連携による高次脳機能障害者への自動車運転再開支援

Supporting resumption of automobile driving for persons with higher brain dysfunction through multi-professional collaboration

　当指定自動車教習所は，医療機関から神経心理学的検査などの情報提供を受けて，高次脳機能障害者に対し，運転適性検査器や実車評価を行っている．岩城ら（2019）が，高次脳機能障害者36名を対象とし，実車指導の前後に実車評価を行って前後比較したところ，評価項目19のうち13項目に有意水準5％にて有意差がみられ，改善を認めた．このことから，実車指導後の実車評価に基づいて運転再開を検討する必要があるといえる．ただし，実車評価は，時間や交通状況に限りがあることから，運転適性を評価しているに過ぎない．こうしたことから，実車評価のみならず，神経心理学的検査や運転適性検査器の結果を関連付けて，前向き・後ろ向きに分析し，多職種連携のもと個々人の運転再開を検討することが，評価としての妥当性や信頼性を高めることにつながるものと考える．

　Our driving school provides driving aptitude test equipment and on-the-road vehicle evaluations for persons with higher brain dysfunction after receiving their neuropsychological test results and other relevant information from medical institutions. Iwaki et al. (2019) evaluated 36 patients with higher brain dysfunction before and after in-car driving instruction and found significant differences in 13 of 19 assessment items at a 5％ level of significance, indicating improvement. From this, it can be said that the resumption of driving should be considered based on the evaluation of the actual vehicle driving following the actual vehicle instruction. However, real-vehicle evaluation only assesses driving aptitude during a limited time and in limited situations. Therefore, we believe that the validity and reliability of the evaluation can be enhanced by studying the resumption of driving by the individual under multidisciplinary cooperation, not only by evaluating the actual vehicle driving, but also by analyzing the relationship between the neuropsychological test and the driving aptitude test equipment results.