This descriptive study generated a theory that described and explained occupational risk perception in home health care workers (HHCWs). Participants included 29 individual home health care workers who were employed by three home health care agencies. Semi-structured interviews and observations of workers as they went about the work of delivering health care in the home environment generated data which were analyzed using grounded dimensional analysis.

Analysis revealed three general dimensions, each of which represent a perspective of the work process significant to the worker's perception of risks: (1) the physical environment of work, (2) relationships of work, and (3) the institutional structure and requirements of work. In this group of workers, the dimension most salient to risk perception was the physical environment of work. While relevant, the dimensions relationships of work and institutional structure and requirements of work were not as central as the first named to the worker's story. A deliberative process called "tucking away" was revealed to be an important part of the perception process used by workers to assess and manage risks in the work environment. This symbolic deliberative process, while covert and fluent for the expert worker, was a more conscious and less-fluent process for the novice worker. Analysis also uncovered a paradox found to influence the worker's perception of risk. The paradox identifies that the positive attributes of the home care work environment which stimulate and challenge workers may well be the same attributes that contribute to a heightened perception of risk.

The findings serve as the components of a proposed explanatory model of occupational risk perception in home health care workers, which can be used to better understand risk perception in relationship to unstructured and unpredictable work environments.