The technology-dependent child and the socially marginalized family: a provisional framework.

The aim of the grounded theory investigation described in this article was to begin to develop an explanatory model of the transition of technology-dependent children to home- and community-based care that would account for variation in process and outcome. To study the transition process prospectively, the investigation was initiated during discharge planning and continued for 1 year following discharge. Data sources included participant observation at discharge planning meetings; interviews with family caregivers, health professionals, and community informants; videotapes; conceptually relevant literature; and other published documents. Early findings indicate that family social status is a category that can account for significant variation both before and after discharge. Theoretical relationships between family social status and two of the emergent concepts, moral distress and social trajectory, are presented here.