Practitioners’ Perspective on Family-Centered Care With the Hispanic/Latino Population

PURPOSE: This study was an initial investigation of occupational therapy intervention with the Hispanic/Latino population and implications for family-centered practice. Previous research on family-centered care has been limited in scope, focusing on intervention with primarily White, middle-class families. Recent changes in population demographics have implications for family-centered care within occupational therapy. In 2010 the Hispanic/Latino ethnic group comprised 16.3% of the U.S. population and represented the fastest growing ethnic group, increasing 43% from 2000 to 2010 (U.S. Census Bureau, 2010). The aim of this study was to explore the practice of family-centered care with the Hispanic/Latino population from the viewpoint of occupational therapy practitioners.

METHOD: This study used a phenomenological method. On the basis of practice experience, the primary investigator purposively selected seven occupational therapists working in Houston-area outpatient pediatric clinics that serve large numbers of Hispanic/Latino families. Participants were recruited via email and were registered occupational therapists with at least 5 yr of experience working with Hispanic/Latino families. None of the participants were Spanish speaking.

Data collection occurred via a focus group interview. A semistructured interview guide was used to enhance credibility by allowing for reframing, repetition, and expansion of questions. The interview was video recorded and transcribed, and additional field notes were taken by the primary investigator. Transcribed data were analyzed and coded using thematic coding. The code–recode procedure described by Krefting (1991) was used, and data were recoded using NVivo 10 (QSR International, Melbourne, Australia).

RESULTS: As the participants defined family-centered care, a recurring theme of family dynamics was noted. Within this theme, the subthemes of family values and family routine emerged. Participants defined family-centered care through taking into account the family’s values and routine, which affected how they structured their approach to intervention. Participants identified two main barriers to family-centered care with Hispanic/Latino families: cultural differences and language. These barriers affected both the caregiver–practitioner relationship and carryover of therapy recommendations to the home. Participants also described several facilitators of family-centered care, including education, seeing progress, and taking extra time with caregivers and families.

Participants cited two ways for optimizing intervention with this population: by becoming bilingual and by having more time. They felt that by learning Spanish and removing the language barrier, they would be able to provide better care for these families. By having more time available in sessions, they felt they could spend more time engaging in casual conversation with caregivers and thereby build better rapport.

CONCLUSION: Hispanic/Latino families are not well represented within the occupational therapy literature, and research is lacking on how practitioners might negotiate cultural differences while also remaining client centered. By using strategies identified in this study, practitioners may be able to circumvent the issues posed by cultural differences between themselves and the families they work with while also providing care that is truly family centered.

References

Krefting, L. (1991). Rigor in qualitative research: The assessment of trustworthiness. American Journal of Occupational Therapy, 45, 214–222. https://doi.org/10.5014/ajot.45.3.214

U.S. Census Bureau. (2010).The Hispanic population: 2010. Retrieved from https://www.census.gov/prod/cen2010/briefs/c2010br-04.pdf