IRB Number

26-0219-015

Date of Award

Summer 8-2026

Document Type

Capstone

Degree Name

Doctor of Occupational Therapy (OTD)

Department

Occupational Therapy

First Advisor

Dr. Cassandra Nelson

Second Advisor

Dr. Keith McWilliams

Medical Subject Headings

Patients, Caregivers, Home Care Services, Follow-Up Studies, Patient Education as Topic, Activities of Daily Living, Motivation, Occupational Therapy, Sample Size, Communication

Abstract

Home health occupational therapy (OT) supports individuals’ safety, independence, and participation in their natural environments; however, patients and caregivers may face barriers that affect the implementation of therapy recommendations. This capstone project explored patient and caregiver experiences with home health OT and identified factors influencing implementation of OT recommendations. We used a sequential explanatory mixed-methods design guided by the Capability, Opportunity, Motivation–Behavior (COM-B) model. Eight participants, including three patients and five caregivers, completed an electronic survey, and one caregiver participated in a follow-up semi-structured interview. We analyzed quantitative data using descriptive statistics and qualitative data using reflexive thematic analysis. Findings indicated generally positive perceptions of therapist communication, education, and the relevance of OT services. Physical or medical limitations were the most frequently reported barrier to implementation, while family or caregiver support was the most frequently reported facilitator. Therapist encouragement, clear instructions, home adaptations, individualized education, and integration of recommendations into everyday routines also supported implementation. The findings informed the development and refinement of Supporting Success at Home, an evidence-based caregiver education toolkit. Although the small sample size limits the findings, this project highlights the importance of clear communication, individualized recommendations, caregiver involvement, and practical strategies that support implementing home health OT recommendations within daily routines.

Comments

Capstone project submitted to the University of St. Augustine for Health Sciences in partial fulfillment of the requirements for the degree of Doctor of Occupational Therapy.

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