This exploratory study used qualitative research methods to identify values that influence clinical reasoning in occupational therapy. Through an interview format, selected occupational therapists were asked to respond to a predetermined list of questions about a general case study. The interviews were tape-recorded and a content analysis of the tapes yielded 18 distinct value statements. Implications of the findings and recommendations for further studies are presented. Qualitative research methodology is examined for its utility in occupational therapy.

This study investigated rationales underlying splinting decisions involving patients with hemiplegia. The survey incorporated a limited-choice, multiple-option questionnaire based on the case study of a man with a left hemiparesis at three hypothetical stages of recovery. Ninety-three occupational therapists who answered indicated whether they would or would not recommend a splint at each stage, and selected one or more reasons for their decisions. The respondents fell into three major categories: those who would 1. never splint, 2. always splint, and 3. splint only in the presence of moderate to severe spasticity. Those with longer clinical experience reflected more tendency to splint. The results indicated conflicting practices in splinting and showed the need for further clinical research in this area.

This article raises, but does not answer, the kinds of questions that need to be asked by responsible occupational therapists in the 1980s--ethical questions that deal with technological advances on the one hand and limited resources on the other. The article examines moral dilemmas that practitioners and students face when making clinical decisions in a climate where technology and cost containment may overshadow the needs of the individual patient. A review of the literature on clinical reasoning, technology, and cost containment provides the background for a discussion of specific issues of quality of life for the occupational therapist. Implications for education and practice are presented, with suggestions for further consideration.

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