The Barriers and Facilitators Experienced by Primary Caregivers When Implementing Occupational Therapy Home Programmes Within a Primary Healthcare Setting

Abstract

Introduction This study aimed to describe and explore the facilitators and barriers that primary caregivers experience when implementing an occupational therapy home programme. Methods An exploratory, descriptive qualitative research design was used. The researcher conducted semi-structured interviews with 12 primary caregivers attending Hillbrow Community Health Centre. Purposive sampling methods were used to gather participants involved in the study and participants were sources largely from outpatient groups for children with Cerebral Palsy and Down syndrome. Findings The data gathered from the 12 semi-structured interviews were analysed using thematic analysis. Four themes were generated throughout this process, namely: family dynamics; “sometimes he just doesn’t want to”:-child-centric factors; faith, strength and responsibility and, “it’s hard, it’s complicated”: the broader context. These themes described how factors in the primary caregivers’ immediate household contexts as well as the broader socioeconomic contexts of their communities contributed to their ease or difficulty they experienced when implementing occupational therapy home programmes. While it was found that these themes described the facilitators and barriers that primary caregivers experienced, they were not experienced in isolation and it was an interplay of factors between the primary caregiver, the child and contextual factors that influenced the home programme implementation. It was found that surprisingly few barriers related to the home programme activities themselves and that a consolidated understanding of the home programme activities was important for effective implementation. This study found that the interaction between the primary caregivers, children and household context contributed to the primary caregivers’ opportunity to implement the home programme activities. Conclusion This study aimed to describe facilitators and barriers that influenced how primary caregivers implemented occupational therapy home programmes. All primary caregivers interviewed managed to implement the programmes but provided insight into what factors within their immediate and broader environments and contexts made it easier or more difficult to implement the home programme activities. This insight showed how v | P a g e factors and resources within their household and broader socioeconomic environments were a greater influence on implementation than the home programme activities themselves. This insight is important for occupational therapists to understand when prescribing home programmes and working with children with disabilities and their primary caregivers.