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Clinical Reasoning Guideline for Home Modification Interventions.

Susan L Stark1, Emily Somerville2, Marian Keglovits3

  • 1Susan 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.

The American Journal of Occupational Therapy : Official Publication of the American Occupational Therapy Association
|July 1, 2015
PubMed
Summary

Occupational therapists now have a new clinical reasoning tool to guide home modification interventions. This validated guideline helps therapists systematically address personal and environmental factors for improved client care.

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Area of Science:

  • Occupational therapy
  • Clinical reasoning
  • Health intervention research

Background:

  • Home modification interventions are complex and require sophisticated clinical reasoning.
  • The clinical reasoning process of occupational therapists in this context is often considered a 'black box'.
  • A structured approach is needed to enhance the consistency and effectiveness of these interventions.

Purpose of the Study:

  • To develop a clinical reasoning tool for occupational therapists.
  • To validate the tool for use in home modification interventions.
  • To describe and support the clinical reasoning process in this specialized area.

Main Methods:

  • A two-phase, mixed-methods approach was employed.
  • Phase 1 involved qualitative data collection (interviews, focus groups, observations) with experts to develop a guideline.
  • Phase 2 involved validation of the developed guideline by a second group of experts.

Main Results:

  • A clinical reasoning guideline was developed, identifying 16 key personal and environmental factors.
  • Each factor included corresponding conditions and strategies for intervention.
  • The guideline was successfully validated by a panel of home modification experts.

Conclusions:

  • A novel clinical reasoning tool has been created for occupational therapists.
  • This tool aids in understanding and applying clinical reasoning during home modification interventions.
  • The guideline facilitates the delivery of complex interventions with improved fidelity.