Determining the Need for Client 24-Hour Supervision: A Cross-Sectional Survey of Occupational Therapists

Abstract

This study explored how private practice occupational therapists determined whether their clients’ need 24-hour supervision, including assessments used, modes of clinical reasoning and therapists’ confidence in their determinations. Survey data from 90 participants were analyzed using descriptive statistics. Participants reported using 166 different assessments to inform decisions about 24-hour supervision and most frequently engaged in pragmatic and conditional reasoning. On average, therapists perceived that they were confident or very confident in their determinations. There is variability in how therapists assess and reason through when 24-hour supervision may be required. Research to develop practice guidelines in this area is needed.

Keywords:

• Assessment
• attendant care
• clinical reasoning
• occupational therapy

Acknowledgment

We gratefully acknowledge the occupational therapists who completed this study’s pilot survey and provided feedback during this study’s development stages as well as all participants who completed the survey.

Disclosure of Interest

The authors report no conflict of interest.

Data availability statement

Due to the nature of this research, participants of this study did not agree for their data to be shared publicly, so support data is not available.

Additional information

Funding

This research received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Emily Nalder holds the Canada Research Chair (Tier 2) in Resiliency and Rehabilitation, funded by the Canadian Institutes of Health Research, as well as the March of Dimes Canada Paul J. J. Martin Early Career Professorship.

Notes on contributors

Kendra Flemming

Kendra Flemming, MScOT. OT Reg. (Ont). At the time of this study, she was a student in the Master of Science in Occupational Therapy program at the University of Toronto. Currently she is an adult homecare occupational therapist.

Richard Ferri

Richard Ferri MScOT. OT Reg. (Ont).At the time of the study, he was a student in the Master of Science in Occupational Therapy at the University of Toronto. He is currently and Occupational Therapist working in private practice with individuals who have been in motor vehicle collisions.

Mathew A. Rose

Mathew A. Rose. BSc. OT OT Reg. (Ont), CCLCP, status-only lecturer, Department of Occupational Science and Occupational Therapy at the University of Toronto, and Principal of Mathew Rose and Associates, Medical-Legal Consultants.

Avelino (Jun) Maranan

Avelino (Jun) Maranan Jr. OTD, MHM, MClSc, OT Reg. (Ont.) is a status-only lecturer in the Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Canada.

Emily Nalder

Emily Nalder, PhD, OT Reg. (Ont.). Is an Assistant Professor in the Department of Occupational Science and Occupational Therapy at the University of Toronto. Her research areas include cognitive rehabilitation, and exploring community integration resiliency and adaptation after acquired brain injury.