PHYSICAL THERAPIST'S PERSPECTIVE OF FAMILY-PROVIDER RELATIONSHIPS IN PEDIATRIC HOME VISITS

Purpose/Hypothesis: This study explored the Early Intervention (EI) physical therapists’ lived experience regarding family-provider relationships providing home-based therapy.

Number of Subjects: Twelve participants completed 60-minute semi-structured, virtual interviews that were recorded and transcribed via Zoom Cloud.

Materials/Methods: A phenomenological approach guided this qualitative study. Purposeful sampling of PTs with over five years experience providing home physical therapy in the Northeast region was completed. Twelve participants completed 60-minute semi-structured, virtual interviews that were recorded and transcribed via Zoom Cloud. Each transcript was de-identified and then emailed to the participant for member checking. Data was analyzed with two rounds of open coding, followed by axial coding with bracketing to minimize bias. Emergent themes were member-checked before final themes were developed. Saturation was reached at twelve participants.

Results: Two themes emerged, each with three subthemes: trusting relationships evolved over time and unique obstacles for home-based PTs. The first theme established that parent-provider relationships were grounded in trust and open communication and evolved into therapeutic partnerships. On the first visit, clear, realistic expectations are facilitated in a supportive environment based on collaboration. This develops close, non-judgmental connections with families, empowering them to buy into therapy and support their involvement. Relationships evolve through an understanding of the family and can extend beyond discharge due to their depth.

Working in diverse homes is normalized for therapists, but unique obstacles are still present when establishing effective partnerships. PTs consider safety, cleanliness, and personal boundaries when entering the home while maintaining professionalism. Despite the struggles and potential discomfort, PTs experience a sense of pride and joy associated with working in a family’s home. Overall, working in the home provides unique opportunities for the providers to develop a supportive relationship with the families and to work collaboratively for the child’s well-being.

Conclusions: Participants reported a strong bond that began on the first visit and evolved into a mutual feeling that the therapist was “part of the family.” Open communication, non-judgmental support, and trust were fundamental to a successful PT and family relationship. Some participants used terms such as “my kiddos” and “my families” to protect confidentiality, while others utilized them to display a connection to the family. Despite environmental and safety challenges, participants reported high career satisfaction related to feelings of appreciation and family connection.

Clinical Relevance: A stronger understanding of the family-provider relationship will assist new EI clinicians in forming effective partnerships leading to better outcomes for the children and may encourage new graduates to work in this setting.