Using Hermeneutics to Understand Burnout and Coping Strategies Utilized by Occupational Therapists

Since the 1990's occupational therapists in Canada have continued to practice in an ever-changing landscape. Drastic cutbacks in public health spending have resulted in hospital closures and transfer of services into the community. Health system reforms in the first decade of the 21st century were primarily directed towards cutting costs, gaining efficiencies, integrating new technologies and meeting the needs of a more informed health consumer (von Zweck, 2004). Education requirements for entry-level therapists have changed as well with a move to a professional master's training in 2008 (von Zweck, 2004). While the publicly funded system struggles with providing services, growth areas include self-employment and providing services for profit. These rapid changes have had an impact on how occupational therapy is practiced in the community, hospitals and chronic care/rehabilitation settings. Wilkins (2007) in her study for Statistics Canada reviewed and analyzed the data from the 2003 Canadian Community Health Survey (CCHS) which surveyed nearly one in three employed Canadians (approx 5.1 million). This study reported that 47% of occupational therapists found most days at work as "quite" to "extremely" stressful. This study also ranked occupational therapists as the seventh most stressed health care provider behind nurses, medical lab technicians, and specialist and family physicians. This article reports on the qualitative aspects of a mixed method research study, which sought to expand existing knowledge on the stressors experienced by occupational therapists (OTs) practicing in Ontario, Canada. The study goals included the elucidation of the practice issues the participants face in their work life and the coping strategies they utilize to prevent burnout. The first author, Sangeeta had eleven years of clinical practice as an occupational therapist (OT) when she started her Masters' degree under the supervision of the second author Margo who is a professor in OT at Queen's University. We agreed that it would be helpful to bring two other experts on as advisory committee members, Claudia who is the Executive Director of the Canadian Association of OTs and Rosemary who is a faculty member at Queen's University and also past president of the Ontario Society of OTs. Literature Review Madill et al. (1985) surveyed 119 Alberta occupational therapists using the Life Roles Inventory and personal interviews. The participants had either left the profession or changed their area of practice to move outside of the traditional occupational therapy practice setting. The authors identified several themes to elucidate career patterns from the findings. The study revealed that most occupational therapists sought work in a setting where they had had a challenging and a successful work placement experience. It also indicated that occupational therapists usually sought out a second employment setting despite a first negative experience, but if that new practice setting failed to meet their needs, the likelihood of remaining in a traditional practice setting was very low. The study found the average age of someone leaving or changing the profession was below 40 years of age. While this study was conducted more than 25 years ago, I believe it is relevant to include it here as a Canadian study. I did wonder if there would be differences in levels of burnout between new graduates and senior occupational therapists. Rogers and Dodson (1988) surveyed 99 occupational therapists practicing in the southeastern US using the Maslach Burnout Inventory-Human Services Survey (MBI-HSS) and reported that, on average, occupational therapists experienced less burnout (especially emotional exhaustion and depersonalization) than other human service professionals. They also noted that occupational therapists' scores on personal accomplishment were comparable to the normal sample. A study by Bailey (1990a, 1990b) surveyed 696 occupational therapists using a 54-item questionnaire. …