Complex Negotiations at the Kitchen Table: A Qualitative Analysis of Pediatric Home Modifications

Occupational therapists assess and make recommendations for modifying home environments to facilitate caregiving of children in their homes. Children who are profoundly and permanently physically disabled remain dependent for their care throughout their lifespan. As they mature, the physical demands on family members to provide care become more challenging requiring major modifications to ease caregiving. Qualitative interview data of ten educationally influential occupational therapists (EIOTs) were collected to examine what information the EIOTs collect and how they prioritize and organize these data to make modification recommendations. The data were analyzed using grounded theory methodology. The findings detail myriad information required by the EIOT to make recommendations for modifications. Findings suggest a future oriented and highly contextualized information gathering process. The themes were integrated into a process model that suggests how therapists may be developing recommendations. The findings highlight important implications for research, education, clinical practice and service delivery policy.MAS