Clinical Reasoning Guideline for Home Modification Interventions

Am J Occup Ther. 2015 Mar-Apr;69(2):6902290030p1-8. doi: 10.5014/ajot.2015.014266.


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.

MeSH terms

  • Adult
  • Decision Making*
  • Environment Design*
  • Focus Groups
  • Housing*
  • Humans
  • Middle Aged
  • Occupational Therapy*
  • Patient-Centered Care*
  • Practice Guidelines as Topic
  • Reproducibility of Results