[The transformation process among a group of heart patients followed in ergotherapy with the aim of modifying the balance of occupation]. / Processus de transformation chez un groupe de personnes cardiaques suivies en ergothérapie pour une modification de leur équilibre du fonctionnement occupationnel.

Transformative learning is a process of adaptation that allows for profound personal change in occupational therapy clients. This process is provoked by a triggering factor, such as illness, which results in a critical reflection on values, beliefs, feelings and personal knowledge associated with the object of change (Mezirow, 1991). As part of an objective aimed at modifying the balance of occupation, nine participants were interviewed over a 6 month period to explore their processes of change. Eight concepts related to the objective of change of the balance of occupation emerged from an inductive data analysis process (Glaser and Strauss, 1967). The perception of work was interpreted by the authors as having undergone the most significant sense of transformation amongst the participants. Two other perceptions, 1) the definition of self and 2) the concept of health emerged as new elements essential to the modification of the balance of occupation. The transformation process linked to these eight concepts revealed a specific structure and sequence. The results highlight the primary role of critical reflection amongst occupational therapy clients and underline the importance of deconstructing common values and beliefs which could slow down the process of change. Moreover, the development of new values and beliefs is a vehicle for change in occupational therapy.

Occupational therapists' perceptions of evidence-based practice.

Occupational therapists are increasingly urged to carry out evidenced-based practice; however, little is known regarding their present practice and perceptions of evidence-based practice. To explore this phenomenon, a qualitative study was completed using a grounded theory approach. Semi-structured interviews were carried out with eight occupational therapists who worked in diverse practice settings. Participants were asked to reflect on their own views of evidence-based practice and their use of evidence in therapy. Data were analyzed inductively using constant comparison analysis. Participants' perceptions of evidence-based practice were described in three broad categories. To these occupational therapists, evidence-based practice is: (a) a process of looking for understanding; (b) associated with research, and; (c) a potential threat to the occupational therapist. These findings produce a basis from which recommendations are made to increase the use of evidence-based practice by occupational therapists.