Clinical Reasoning Guideline for Home Modification Interventions

Author:

Stark Susan L.1,Somerville Emily2,Keglovits Marian3,Smason Aliza4,Bigham Kelsey5

Affiliation:

1. Susan L. Stark, PhD, OTR/L, FAOTA, is an Assistant Professor of Occupational Therapy, Neurology and Social Work, Washington University School of Medicine, St. Louis, MO; starks@wusm.wustl.edu

2. Emily Somerville, MSOT, OTR/L, is Occupational Therapist, Washington University School of Medicine, St. Louis, MO

3. Marian Keglovits, OTD, MSCI, OTR/L, is Occupational Therapist, Washington University School of Medicine, St. Louis, MO

4. Aliza Smason, OTD, OTR/L, is Occupational Therapist, Ministry of Education, Jerusalem, Israel

5. Kelsey Bigham, MSOT, OTRl/L, is Occupational Therapist, Jones Therapy Services, Nashville, TN

Abstract

Abstract OBJECTIVE. The objective of this study was to develop and validate a clinical reasoning tool to describe an occupational therapist’s clinical reasoning process while delivering home modification interventions. METHOD. We used a two-phase, mixed-methods approach. In Phase 1, we developed a personal factors guideline to support clinical reasoning in home modification interventions based on in-depth interviews, a focus group, and field observations of 6 home modification experts. In Phase 2, the guideline was validated by a second group of 6 home modification experts. RESULTS. During analysis, 16 personal and environmental factors with a corresponding set of conditions and strategies for each factor emerged to form a clinical reasoning guideline, which was validated by a second group of experts. CONCLUSION. Unpacking the “black box” of the clinical reasoning process has yielded a useful clinical reasoning tool that will allow occupational therapists to deliver complex interventions with fidelity.

Publisher

AOTA Press

Subject

Occupational Therapy

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