交通心理学的なコーチングを用いたセカンドオピニオンの脳卒中後症例の運転再開経験

Driving resumption for a second opinion post-stroke patient through traffic psychological coaching

要旨：自動車運転再開支援では，対象者の運転能力を包括的に捉えることが求められる．今回，過去3回の運転評価で全般性注意機能低下と危険運転行動により運転再開不可とされた70代男性に対し，交通心理学のアプローチを用いた介入を実施した．当院における院内初期評価ではSiDSのタイミング検査や反応時間の遅延，教習所内コース評価では一時停止やカーブ進入前のブレーキ操作の遅れ，自身の運転のモニタリングの不十分さが観察された．交通心理学のアプローチに基づくブレーキ操作の反復訓練と教習指導員による公道での実地走行の結果，ブレーキ操作や運転パフォーマンス，自身の運転に関するメタ認知に変化を認め，最終的に運転再開に至った．

　Supporting the resumption of driving requires a comprehensive assessment of the client's driving ability. In this study, we conducted the occupational intervention through the traffic psychology approach in the case of a man in his seventies who had been deemed unable to resume driving due to generalized attention deficits and dangerous driving behavior at three previous driving evaluations. We observed delays in SiDS timing tests and reaction times in the initial in-hospital evaluation, as well as delays in braking before stopping temporarily, entering a curve, and inadequate monitoring of his own driving during the in-course evaluation. We conducted repeated training in braking based on a traffic psychology approach and actual driving on public roads by a driving instructor. We observed an improvement in braking, driving performance, and metacognition of his own driving, which eventually lead to a resumption of driving.