Abstract
Home health is by definition intermittent treatment. The voluntary participation of the patient and family in working toward goal achievement, especially in the absence of the practitioner, greatly affects the effectiveness of the occupational therpist. Improving that participation requires a thoughtful understanding of the value system of the patient and creative, flexible programming. The unique effects that the sociocultural experiences of patients have on the treatment process in home health care are discussed according to a set of facotrs that influence his compliance with care. Research findings and a brief case study shall illustrate some of the factors.

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