Liz Smythe

The interconnected meanings of occupation: The call, being‐with, possibilities

While a range of literature has explored the meaning of occupation, the lived experience of occupation has been relatively neglected. In this hermeneutic phenomenological study 12 New Zealand adults who had experienced a disruption to their occupations were interviewed, on the assumption that disruption reveals things that are usually overlooked. The data were analysed by identifying key themes and engaging in a hermeneutic process informed by the philosophies of Heidegger and Gadamer. The findings suggest that the meaning of occupation is complex and tends to remain hidden. Three facets of meaning that work in unison, each interconnected with the other, emerged from analysis; the Call, Being‐with and Possibilities. The findings of this study are considered in relation to selected literature, to build on current understandings of the meaning of the occupation. While the study is acknowledged to have limitations in terms of sampling, the findings do have implications for occupational science which include building on knowledge of the meaning of occupation and considering occupation from a context wider than that of the individual.

A Phenomenological Study of Occupational Engagement in Recovery from Mental Illness

Background. Recovery from mental illness has been described as a process involving personal growth and a search for meaning. Occupation is a primary medium for human development as well as the creation of life meaning, suggesting the exploration of recovery from an occupational perspective is warranted. Purpose. To explore the experience and meaning of occupation for 13 people who self-identified as being in recovery from mental illness. Methods. Recovery narratives were collected from participants in conversational interviews that were recorded and transcribed. The transcripts were analysed using hermeneutic phenomenology. Findings. A range of experiences were evident in the recovery narratives, from complete disengagement to full engagement in occupations. Insights into the experience and meaning of different states of occupation were revealed. Implications. All forms of occupational engagement, including disengagement, can be meaningful in the recovery process. Increased understanding of different modes of occupational engagement will assist therapists to support recovery more effectively.

Exploring the Meaning of Occupation: The Case for Phenomenology

Background. Some authors are beginning to challenge current categorisations of occupation as self-care, productivity, and leisure in favour of categories that address meaning. However, the meaning of occupation receives relatively little attention in the literature. Purpose. To provide a synthesis of the contemporary literature that considers the meaning of occupation and to argue that phenomenological insights into the meaning of occupation might usefully inform occupational therapy research, theory, and practice. Key Issues. Meaning is a key aspect of occupation. Three phenomenological meanings of occupation uncovered by a study conducted in New Zealand—the call, Being-with and possibilities—provide a starting point for practice, research, and theory informed by understandings of the lived experience of occupation. Implications. Occupational therapys theories would benefit from an evidence base that includes meaning, which in turn would lead to authentic occupational therapy practice.

Chronic Pain: Gaining Understanding through the Use of Art

Many people have chronic pain yet little is known about what it is like to live with pain on a permanent basis and how this experience affects people. This article reports the findings of a phenomenological study into the meaning of chronic pain for 14 people who were attending a pain management programme in New Zealand. The data for the study comprised artwork produced by the participants in the course of the programme and their explanation of its meaning. Five main themes emerged from the data analysis: gaining pain and losing self, redefining self, identity through others, being hopeful and being on a journey. The study found a strong association between participation in valued occupation, the maintenance and redefinition of identity, experiencing oneself as competent and being hopeful about the future. The research process supported the use of art as an expressive medium in occupational therapy.

Caesarean-section, my body, my choice: The construction of 'informed choice' in relation to intervention in childbirth

The notion of choice, especially of informed choice, is a central tenet of maternity services in most western countries; it also underpins debate about rising rates of intervention that are now a feature of childbirth in many of these countries. Our study investigated the shaping of understanding and practice in relation to these rising rates of intervention in childbirth in the New Zealand context. Critical hermeneutics was used to analyse the data from interviews with nine midwives and obstetricians, and six focus groups with 33 women. This article reports on the notion of choice, which featured prominently in all the interviews. It became clear that women’s choices were strongly influenced and determined by social change, by the gendering of women, and by values such as control, predictability, convenience, the ‘quick fix’ and the normalization of surgery. We argue that the prevailing notion of ‘informed’ choice obscures the structural and social influences on ‘choice’.

Crafting Stories in Hermeneutic Phenomenology Research A Methodological Device

Hermeneutic phenomenology, as a methodology, is not fixed. Inherent in its enactment are contested areas of practice such as how interview data are used and reported. Using philosophical notions drawn from hermeneutic phenomenological literature, we argue that working with crafted stories is congruent with the philosophical underpinnings of this methodology. We consider how the practical ontic undertaking of story crafting from verbatim transcripts is integral with the interpretive process. We show how verbatim transcripts can be crafted into stories through examples taken from interview data. Our aim is to open dialogue with other hermeneutic phenomenological researchers and offer alternate possibilities to conventional ways of work with qualitative data. We argue that crafted stories can provide glimpses of phenomena that other forms of data analysis and presentation may leave hidden. We contend that crafted stories are an acceptable and trustworthy methodological device.

Ankle sprains: patient perceptions of function and performance of physical tasks. A mixed methods approach.

Purpose. To investigate patients perceptions of function and performance of physical tasks after discharge from treatment for an ankle sprain. Methods. Using a mixed methods approach, 40 participants who presented with an acute sprained ankle and their treating clinicians completed two questionnaires related to function at the start and end of a rehabilitation programme. Additionally, participants completed the questionnaires at 6 weeks following discharge at which time they also performed physical tasks that were still perceived as difficult. Ten participants also completed a semi-structured interview. Results. There were no significant differences (p  >  0.05) in the participants and clinicians initial assessment of function. However, at discharge participants scored their function significantly (p  <  0.05) lower than clinicians. This difference was not apparent 6 weeks later (p  >  0.05). However, there was a significant difference (p   <  0.05) following actual performance of tasks with an effect size of 1.58. Participant interviews confirmed that patients had a fear of re-injury until they actually performed tasks that were perceived as difficult. Conclusions. Clinicians and participants do not have a similar perception of the recovery of an ankle sprain at discharge. Performing tasks which were perceived as difficult were valuable in assisting participants gain an improved appreciation of their function.

The Meaning of Occupation: A Hermeneutic (Re)view of Historical Understandings

This article reports the findings of an analysis of historical and contemporary literature which explored how the meaning of occupation has changed over time. A hermeneutic approach, based on the work of Gadamer, focuses on changes of meaning. The core idea of reviewing literature published over a very wide and ancient span of time was to bring the notion of occupation to the fore and shed light on how meanings of occupation are culturally embedded. This article focuses on Western sociology, history, philosophy and leisure texts that ranged from Ancient Greek and Roman times to the Industrial Revolution. The exploration showed that while the word ‘occupation’ did not exist until the 12th century, there were rich descriptions of what occupational scientists now understand as occupation. While the meaning of occupation per se may have been hidden during these early times, there were many influences that contributed to both the understanding and experience of occupation. Highlighting how historical factors have contributed to culturally embedded meanings provides occupational scientists with insights into the way what is called ‘occupation’ is shaped, which in turn has the potential to influence current and future scholarship.

The Sounds of Silence—A Hermeneutic Interpretation of Childbirth Post Excision

Four women who had been excised were interviewed about their experiences of giving birth. Using hermeneutic phenomenology we analyzed their narratives to more fully understand their experiences of childbirth in the context of excision. Childbirth is characterized by silence related to excision. To ensure safe care, increased communication is needed. The onus for opening channels of communication rests with health professionals whose aim is to provide safe, appropriate care to women and their families. In this article we give voice to womens call for sensitive communication that acknowledges their excision and supports them through the challenges it presents for birth.

Valuing the lived experience: a phenomenological study of skiing*

Abstract Hermeneutic phenomenology is a little used approach in sport settings yet is widely advocated in other disciplines (e.g. health research). This article contributes to the theoretical understanding and practical application of hermeneutic phenomenology in sport research. It considers and explores the lived experience of skiing through a phenomenological approach and in so doing exposes a deeper understanding into the meaning skiing may hold in the lifeworlds of those who ski. Such research highlights the growing use of interpretive paradigms to elucidate lived experience in sport research, contrasting measurement of experience with seeking to understand the experiences themselves. We assert that hermeneutic phenomenology has much to offer sport research where an understanding of how one’s subjective encounter can reveal much about the shared knowings, meanings and experiences of participation in sport in our society.