Housing adaptations from the perspectives of Swedish occupational therapists

Abstract

The aim of this study was to investigate how occupational therapists in Sweden administer housing adaptation cases, how they perceive the housing adaptation process, and which improvements they consider necessary. A total of 1,679 occupational therapists employed by county councils or local authorities (and are involved in housing adaptations) participated in a web-based survey. The survey targeted issues related to referral and needs identification, assessment, certification, case progress feedback and evaluation. Less than half of the occupational therapists systematized the assessment prior to intervention and very few conducted any evaluation afterwards. Feedback from workmen or grant managers to the occupational therapists on each case's adaptation progress was rare but asked for. The majority of the participants were satisfied with the housing adaptation process in general, while at the same time they indicated a need for further improvements of the process.Differences between occupational therapists related to employer and year of graduation were found on the majority of the targeted issues. To conclude, a very large extent of housing adaptations seem to be based on non-standardized procedures for assessment, and only few of them are evaluated systematically.Keywords: web-based survey, case management, evidence-based practice, home modification. Housing adaptations from the perspectives of Swedish occupational therapistsAbstract: The aim of this study was to investigate how occupational therapists in Sweden administer housing adaptation cases, how they perceive the housing adaptation process, and which improvements they consider necessary. A total of 1,679 occupational therapists employed by the county councils' or the local authorities (and are involved in housing adaptations) participated in a web-based survey. The survey targeted issues related to referral and needs identification, assessment, certification, case progress feedback and evaluation. Less than half of the occupational therapists systematized the assessment prior to intervention and very few conducted any evaluation afterwards.Feedback from workmen or grant managers to the occupational therapists on each case's adaptation progress was often asked for but rarely given. The majority of the participants were satisfied with the housing adaptation process in general, while at the same time they indicated a need for further improvements of the process. Differences between occupational therapists related to employer and year of graduation were found on the majority of the targeted issues. To conclude, to a very large extent of housing adaptations seem to be based on non-standardized procedures for assessment, and only few of them are evaluated systematically.2

A research-based strategy for managing housing adaptations: study protocol for a quasi-experimental trial

“…The new practice strategy is based on extensive research conducted over the years, including both our own research [ 4 – 7 , 20 , 29 , 41 , 43 ] and that of other researchers [ 56 , 57 ]. The intervention in this study has been developed and tested through many years of research and in discussion with practitioners.…”

“…The intervention in this study has been developed and tested through many years of research and in discussion with practitioners. This process has included methodological development and testing see, e.g., [ 29 , 58 , 59 ], research aimed at identifying the most important outcomes see, e.g., [ 6 – 8 , 18 , 46 , 57 ] and research targeting current HA case-management procedures in Swedish municipalities [ 20 ]. Since complex interventions comprise multiple components that are interrelated or interdependent they can be challenging to develop, document, evaluate, and report.…”

“…Since complex interventions comprise multiple components that are interrelated or interdependent they can be challenging to develop, document, evaluate, and report. However, based on knowledge on the wide variation of how the OTs structure their work on HA [ 20 ] studies like these are needed to develop evidence based practice.…”

“…In relation to needs assessment and evaluation, a web-based survey targeting Swedish OTs (N =1,679) [ 20 ] showed that most HAs were based on unstructured assessments and non-evidence-based methods and that follow-ups were rarely undertaken. Swedish guidelines for management of the HA process are not based on research and are to large extent insufficient.…”

Falls and Fear of Falling among Persons Who Receive Housing Adaptations—Results from a Quasi-Experimental Study in Sweden

“…Systematic approaches to housing adaptation management are used to some extent [ 30 ], but the majority of housing adaptations are implemented without making use of current evidence, applying unstructured methodology [ 31 , 32 ]. The Swedish housing adaptation legislation states that the aim is to facilitate an independent lifestyle for those with disability in their own home.…”