Clinical reasoning guideline for home modification interventions

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.