Pontos de vista sobre deficiência e incapacidade entre fisioterapeutas brasileiros: um estudo Q

Abstract

Introduction: The discourses of health professionals, particularly physiotherapists, on disability have the potential to exert a significant social influence, particularly on the lives of their disabled patients. However, this topic has rarely been empirically investigated. Furthermore, traditional qualitative and quantitative methods may be inadequate for fully appreciating the complexity of meanings or for objectively identifying the diversity of viewpoints. Objective: To concisely distinguish current discourses on disability among a diverse group of Brazilian physiotherapists. Methods: A cross-sectional Q-study was conducted with a diverse purposive sample of Brazilian physiotherapists. The Q-set comprised 59 statements representing diverse perspectives on various aspects of disability. These statements were derived from a Q-concourse of 182 sentences, which had been extracted, adapted, or elaborated from a comprehensive literature review on models of disability and from two other studies on the subject: a Q-study conducted by McKenzie et al. (2011) and a qualitative survey conducted by Vaz et al. (2023). Results: Fifty-three participants from many diverse contexts completed their participation. Factor analysis produced three orthogonal factors, so named: 1) Context-accounting Biomedical View; 2) Socio-psycho-biological View; 3) Realist-Antiableist View. Biopsychosocial ideas were present in all points of view; point of view 1 has a strong biomedical emphasis; point of view 2 slightly favors social ideas; point of view 3 values anti-capacitist ideas. They all try to reject prejudice, but point of view 1 fails to be consistent in this effort. Conclusion: The existing literature on conceptions of disability is typically associated with either hermetic theoretical models or subjective opinions, which are frequently inadequately delineated. The Q method allowed for characterizing PTs’ conceptions within three clearly distinguishable points of view, reflecting varying degrees of emphasis on biopsychosocial, biomedical, social and anti-ableist/affirmative perspectives in understanding and responding to disability.