Conceptions of disability among physiotherapists: an exploratory qualitative study

Area of Science:

• Rehabilitation Science
• Disability Studies
• Health Professions Education

Background:

• Physiotherapists' (PTs) underlying assumptions about disability significantly influence patient care and practice.
• These assumptions may not align with the International Classification of Functioning, Disability, and Health (ICF) framework.
• Unquestioned beliefs can perpetuate specific models of disability, impacting patient outcomes.

Purpose of the Study:

• To examine how physiotherapy students and clinicians conceptualize disability.
• To determine if these conceptions align with medical, social, or biopsychosocial models, particularly in relation to the ICF.
• To identify potential barriers to adopting a comprehensive biopsychosocial understanding of disability.

Main Methods:

• Qualitative study employing focus groups with physiotherapy students (early and late training) and practicing clinicians.
• Content analysis was used to identify definitions, causes, judgments, and proposed solutions related to disability.
• Investigated conceptions of functioning and disability within different stages of professional development.

Main Results:

• While some participants showed an interactive, biopsychosocial view of disability, a strong medical model predominated across all groups.
• Medical definitions and causal attributions (impairment leading to disadvantage) were common.
• Negative moral judgments associated disability with loss, yet proposed solutions often included social and interactionist strategies, such as combating ableism.

Conclusions:

• Physiotherapy training reveals paradoxical conceptions of disability, blending medical and social elements.
• There's a need for deeper understanding of non-medical disability frameworks to fully leverage the ICF.
• An uncritical adoption of the ICF risks neutralizing its potential to challenge ingrained medical perspectives on disability.