Investigating the effect strength of positive risk-taking barriers on discharge decisions in occupational therapy intermediate care: a factorial survey

Introduction: Positive risk-taking in occupational therapy intermediate care is a requirement, yet little is known about how positive risk-taking barriers influence discharge decisions at different experience levels. Method: A factorial survey was used to investigate positive risk-taking barriers (Limited Capacity, Risk Averse Family, Blame Culture and No Support). Participants self-categorised their experience level into Novice or Semi-expert or Expert before analysing four vignettes relating to recommending a home discharge for an older adult. Data were analysed using Multiple Regression and One-Way Analysis of Variance. Results: Seventy-four participants responded to two hundred eighty-one vignettes. The barriers that reduced the likelihood to recommend a home discharge for an older adult were 'No Support', Novices (beta = -0.315, p = 0.002), Semi-experts (beta = -0.313, p = 0.001) Experts (beta = -0.254, p = 0.009); 'Limited Capacity', Novices (beta = -0.305, p < 0.003), Semi-experts (beta = -0.254, p = 0.006) Experts (beta = -0.376, p = 0.001) and 'Blame Culture' Semi-experts (beta = -0.240, p = 0.010). Novices were found to be less likely to recommend a home discharge by comparison. Conclusion: The 'Limited Capacity', 'No Support' and 'Blame Culture' barriers had the strongest effect and Novices were less likely to recommend a home discharge overall. These findings could inform future research and pre-registration Occupational Therapy education.