Investigating the effect strength of positive risk-taking barriers on discharge decisions in occupational therapy intermediate care: A factorial survey

Newman, Craig, Whitehead, Phillip and Thomson, Mary (2023) Investigating the effect strength of positive risk-taking barriers on discharge decisions in occupational therapy intermediate care: A factorial survey. British Journal of Occupational Therapy, 86 (4). pp. 293-301. ISSN 0308-0226

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Abstract

Introduction:
Positive risk-taking in occupational therapy intermediate care is a requirement, yet little is known about how positive risk-taking barriers influence discharge decisions at different experience levels.
Method:
A factorial survey was used to investigate positive risk-taking barriers (Limited Capacity, Risk Averse Family, Blame Culture and No Support). Participants self-categorised their experience level into Novice or Semi-expert or Expert before analysing four vignettes relating to recommending a home discharge for an older adult. Data were analysed using Multiple Regression and One-Way Analysis of Variance.
Results:
Seventy-four participants responded to two hundred eighty-one vignettes. The barriers that reduced the likelihood to recommend a home discharge for an older adult were ‘No Support’, Novices (β = −0.315, p = 0.002), Semi-experts (β = −0.313, p = 0.001) Experts (β = −0.254, p = 0.009); ‘Limited Capacity’, Novices (β = −0.305, p < 0.003), Semi-experts (β = −0.254, p = 0.006) Experts (β = −0.376, p = 0.001) and ‘Blame Culture’ Semi-experts (β = −0.240, p = 0.010). Novices were found to be less likely to recommend a home discharge by comparison.
Conclusion:
The ‘Limited Capacity’, ‘No Support’ and ‘Blame Culture’ barriers had the strongest effect and Novices were less likely to recommend a home discharge overall. These findings could inform future research and pre-registration Occupational Therapy education.

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