Background. Occupation is a core concept of our profession, yet little is understood about how therapists use occupation in clinical practice. Purpose. This study explores frontline clinicians' experience with occupation-based practice in a large academic health sciences centre. Methods. A qualitative constructivist study was conducted using thematic analysis, following in-depth interviews with 12 occupational therapists. Findings. Participants described the existence of two realities: Occupational therapy as they felt it should be practiced and as it actually is practiced. When the two were incongruent, participants experienced a meaning gap, which was expressed through four themes to reveal that a personal sense of occupation guides practice and transforms the meaning of the job. Implications. The exploration of personal occupational meaning through conscious self-reflection and co-creation of meaning with clients and their health care teams may serve to bridge the meaning gap.
AikenF.FourtA.BaronT.ChengI.LawrenceD.RatansiA. (2006, June). Occupational science and occupational therapy: Exploring clinicians' experience. Paper presented at the Canadian Association of Occupational Therapy Conference, Montreal, QC
2.
AikenF.FourtA.BaronT.ChengI.LawrenceD.RatansiA. (2005, June). An occupational view of health care: Implications for occupational therapy practice at Sunnybrook and Women's. Paper presented at the Practice-based Research Symposium, Toronto, ON
3.
AikenF.FourtA.ChengI.BaronTMenakerLMorrisonD.RatansiA. (2004, May). Occupational therapy and occupational science: The dynamic duo. Paper presented at Canadian Occupational Science Symposium, Toronto, ON
4.
American Occupational Therapy Association. (2002). Occupational therapy practice framework: Domain and process. The American Journal of Occupational Therapy, 56, 609–639. Erratum in: American Journal of Occupational Therapy 2003:57:115
5.
BaumC.BergC.SeatonM. K.WhiteL. (2002). Fostering occupational performance and participation. In LawM.BaumC. M.BaptisteS. (Eds.), Occupation-based practice: Fostering performance and participation (pp. 27–36). Thorofare, NJ: Slack
6.
Canadian Association of Occupational Therapists. (1997). Enabling occupation: An occupational therapy perspective. Ottawa, ON: CAOT Publications ACE
7.
CockerillR.ScottE.WrightM. (1996). Interest among occupational therapy managers in measuring workload for case costing. American Journal of Occupational Therapy, 50, 447–451
8.
CorbinJ.StraussA. L. (2008). Basics of qualitative research: Techniques and procedures for developing grounded theory (3rd ed.). Thousand Oaks, CA: Sage
9.
DenshireS. (2002). Reflections on the confluence of personal and professional. Australian Occupational Therapy Journal, 49, 212–216. doi:10.1046/j.1440-1630.2002.00338.x
10.
DriscollJ.TehB. (2001). The potential of reflective practice to develop individual orthopaedic nurse practitioners and their practice. Journal of Orthopaedic Nursing, 5, 95–103. doi:10.1054/joon.2001.0150
11.
FisherA. G. (2003). Guest editorial: Why is it so hard to practice as an occupational therapist?Australian Occupational Therapy Journal, 50, 193–194. doi:10.1111/j.1440-1630.2003.00419.x
12.
FlemingM. H. (1991). The therapist with the three-track mind. American Journal of Occupational Therapy, 45, 1007–1014
13.
HammellK. W. (2004). Dimensions of meaning in the occupations of daily life. Canadian Journal of Occupational Therapy, 76, 107–114
14.
HasselkusB. R. (2002). The meaning of everyday occupation. Thorofare, NJ: Slack
15.
HaverkampB. E.YoungR. A. (2007). Paradigms, purpose, and the role of the literature: Formulating a rationale for qualitative investigations. The Counseling Psychologist, 35, 265–294. doi:10.1177/0011000006292597
16.
HolsteinJ. A.GubriumJ. F. (2004). The active interview. In SilvermanD. (Ed.), Qualitative research: Theory, method and practice (2nd ed., pp. 140–161). London, UK: Sage
17.
JongbloedL.WendlandT. (2002). The impact of reimbursement systems on occupational therapy practice in Canada and the United States of America. Canadian Journal of Occupational Therapy, 69, 143–152
18.
KielhofnerG. (2004). Conceptual foundations of occupational therapy (3rd ed.). Philadelphia, PA: F. A. Davis Company
19.
KinnL. G.AasR. W. (2009). Occupational therapists' perception of their practice: A phenomenological study. Australian Occupational Therapy Journal, 56, 112–121. doi:10.1111/j.1440-1630.2007.00714.x
20.
KinsellaE. A. (2000). Professional development and reflective practice: Strategies for learning through professional experience. Ottawa, ON: CAOT Publications ACE
21.
LawM.CooperB.StrongS.StewartD.RigbyP.LettsL. (1996). The Person-Environment-Occupation Model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy, 63, 9–23
22.
LincolnY. S.GubaE. G. (1985). Naturalistic inquiry. Newbury Park, CA: Sage Publications
23.
MattinglyC. (1991). The narrative nature of clinical reasoning. The American Journal of Occupational Therapy, 45, 998–1005
24.
MeyerA. (1922). The philosophy of occupational therapy. Archives of Occupational Therapy, 1, 1–10
25.
PierceD. (2003). Editorial: How can the occupation base of occupational therapy be strengthened?Australian Occupational Therapy Journal, 50, 1–2. doi:10.1046/j.1440-1630.2003.00353.x
26.
PolatajkoH. (2001). National perspective: The evolution of our occupational perspective: The journey from diversion through therapeutic use to enablement. Canadian Journal of Occupational Therapy, 68, 203–207
27.
PriceP.MinerS. (2007). Occupation emerges in the process of therapy. The American Journal of Occupational Therapy, 61, 441–450
28.
ReedK.HockingC.SmytheL. (2010). The interconnected meanings of occupation: The call, being-with, possibilities. Journal of Occupational Science, 17, 140–149. doi:10.1080/14427591.2010.9686688
29.
RobertsonC.FinlayL. (2007). Making a difference, teamwork and coping: The meaning of practice in acute physical settings. British Journal of Occupational Therapy, 70, 73–80
30.
SchellB. A. B. (2009). Professional reasoning in practice. In CrepeauE. B.CohnE. S.SchellB. A. B. (Eds.), Willard and Spackmans Occupational Therapy (11th ed., pp. 314–327). Philadelphia, PA: Lippincott Williams & Wilkins
31.
TownsendE. (1998). Occupational therapy language: Matters of respect, accountability and leadership. Canadian Journal of Occupational Therapy, 65, 45–50
32.
TownsendE. A.PolatajkoH. J. (2007). Enabling occupation II: Advancing an occupational therapy vision for health, well-being & justice through occupation. Ottawa, ON: CAOT Publications ACE
33.
SmithK. TrencKinsellaE. A. (2009). Paediatric occupational therapists' reflections on meaning in professional practice: A phenomenological study. Canadian Journal of Occupational Therapy, 76, 299–308
34.
WhitefordG.TownsendE.HockingC. (2000). Reflections on a renaissance of occupation. Canadian Journal of Occupational Therapy, 67, 61–69
35.
WilcockA. (1991). Occupational science. British Journal of Occupational Therapy, 54, 297–300
36.
WilcockA. A. (1998). Reflections on doing, being and becoming. Canadian Journal of Occupational Therapy, 65, 248–257
37.
WilcockA. A. (2006). An occupational perspective of health (3rd ed.). Thorofare, NJ: Slack
38.
WildingC.WhitefordG. (2008). Language, identity and representation: Occupation and occupational therapy in acute settings. Australian Occupational Therapy Journal, 55, 180–187. doi:10.1111/j.1440-1630.2007.00678.x
39.
WildingC.WhitefordG. (2009). From practice to praxis: Reconnecting moral vision with philosophical underpinnings. British Journal of Occupational Therapy, 72, 434–441
40.
WoodW. (2004). The heart, mind, and soul of professionalism in occupational therapy. The American Journal of Occupational Therapy, 58, 249–257. doi:10.5014/ajot.58.3.249
41.
YerxaE. J. (1993). Occupational science: A new source of power for participants in occupational therapy. Journal of Occupational Science, 1, 1–9
