Date Presented 04/22/2023

Communicating with clients and families about health and safety hazards in their homes can be challenging. This study developed guidance for home health care providers about communication strategies to address difficult conversations.

Primary Author and Speaker: Amy Darragh

Additional Authors and Speakers: Sarah Anderson, Barbara Polivka

Contributing Authors: Angela Provenzano, Haley Oliver, Steve Lavender, Carolyn Sommerich

Home healthcare professionals encounter health and safety hazards that impact the health of clients and workers. Mitigating hazards may be difficult; it requires skilled and sensitive negotiation with clients and families. The purpose of this study was to identify health and safety hazards difficult to discuss with clients/families, reasons for the difficulty, and communication strategies for appropriate solutions. The study used an iterative, participatory approach. Background information was collected via the modified Home Healthcare Worker Questionnaire. Group interviews, with a hazard prioritization activity, were used to collect qualitative data. Fifteen home healthcare workers, recruited from local home healthcare agencies, participated in the study. Participants were 93% female; 33% Black, 53% White, and 7% Asian (7% no report); 7% Hispanic; mean age of 51 years. Qualitative analyses were completed in NVivo v12, using constant comparative analyses with triangulation of analysts and data sources and expert review. Participants identified 22 health and safety hazards challenging to discuss with families/clients. These included environmental, slip/trip/lift, and fire/electrical. Reasons for difficulty included client/family factors (eg client mental status), cost/feasibility (eg home modifications), and respect for client autonomy and environment (eg maintain home, not medical, context). Effective communication strategies were shared decision making, team approach, inclusion of families/caregivers, providing choices, clear information about hazards, and direct communication. Occupational therapists identify health and safety hazards during home assessment. This study provides guidance for discussing hazards with clients. Results were integrated into a free video-based app, Home Healthcare Conversations, that provides information about managing health and safety challenges in client homes. This project was funded by the Ohio Bureau of Workers Compensation


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