Newman Craig, Whitehead Phillip, Thomson Mary
Department of Social Work, Education & Community Wellbeing, Northumbria University, Newcastle upon Tyne, UK.
Population Health Sciences Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.
Br J Occup Ther. 2023 Apr;86(4):293-301. doi: 10.1177/03080226221141320. Epub 2022 Dec 13.
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.
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.
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, = 0.002), Semi-experts (β = -0.313, = 0.001) Experts (β = -0.254, = 0.009); 'Limited Capacity', Novices (β = -0.305, < 0.003), Semi-experts (β = -0.254, = 0.006) Experts (β = -0.376, = 0.001) and 'Blame Culture' Semi-experts (β = -0.240, = 0.010). Novices were found to be less likely to recommend a home discharge by comparison.
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.
在职业治疗中级护理中进行积极的冒险是一项要求,但对于积极冒险障碍如何影响不同经验水平的出院决策知之甚少。
采用析因调查来研究积极冒险障碍(能力有限、规避风险的家庭、责备文化和缺乏支持)。在分析与建议一位老年人居家出院相关的四个 vignette 之前,参与者将自己的经验水平自我分类为新手、半专家或专家。使用多元回归和单因素方差分析对数据进行分析。
74 名参与者对 281 个 vignette 做出了回应。降低为老年人推荐居家出院可能性的障碍有“缺乏支持”,新手(β = -0.315,p = 0.002)、半专家(β = -0.313,p = 0.001)、专家(β = -0.254,p = 0.009);“能力有限”,新手(β = -0.305,p < 0.003)、半专家(β = -0.254,p = 0.006)、专家(β = -0.376,p = 0.001)以及“责备文化”,半专家(β = -0.240,p = 0.010)。相比之下,新手不太可能推荐居家出院。
“能力有限”、“缺乏支持”和“责备文化”障碍影响最强,新手总体上不太可能推荐居家出院。这些发现可为未来的研究和职业治疗预注册教育提供参考。