“Back on the road”: Exploring experiences of driving resumption in patients recovering from critical illness

Background Recovery after critical illness is complex, with physical, cognitive, and psychological sequelae. Driving a vehicle involves the intricate interaction of physical, cognitive, visuospatial, and psychosocial components. Any, or all, of these can be impacted by critical illness. Driving resumption and experiences surrounding this activity remain largely unknown from the evidence to date. Objectives To explore the experiences of returning to driving in patients recovering from critical illness and to identify barriers and enablers to driving resumption. Methods This was an exploratory qualitative study. Focus groups were conducted with patients recovering from critical illness enrolled in a 1-year prospective study of supported driving resumption. Focus groups were held face to face at a driving mobility centre in the UK or virtually via Microsoft Teams. Each focus group lasted around 1.5 h. Audio recordings were transcribed verbatim. Data analysis was guided by the principles of reflexive thematic analysis described by Braun and Clarke. Findings Eight individuals participated across two focus groups. Three themes were derived from the data: complexities of recovery and returning to driving after critical illness, reclaiming life through driving, and influential external factors in driving behaviour and recovery. Participants reflected on the adverse effects of critical illness on physical and cognitive ability, resulting in reduced confidence and readiness to drive. Driving resumption was commonly self-directed with limited guidance from healthcare professionals. Greater information and support were desired by survivors. Driving resumption was considered of great importance and was often viewed synonymously with independence and normality. External factors including job roles, public transport, and family perceptions influenced driving resumption and behaviour. Conclusions Findings from this study highlight the importance attributed to driving resumption and the challenges associated with this activity for individuals recovering from critical illness. The need for improved guidance and support to enable safe and timely return to driving was advocated. Registration This study was registered at Clinicaltrials.gov with the ID NCT04272684.