Concepções e atitudes de graduandos e profissionais de fisioterapia em relação à deficiência

Abstract

Conceptions about disability support clinical choices, as well as emotions, thoughts, and behaviors of health care professionals in relation to patients with disability. This qualitative research investigated, through three focus groups, the attitudes and conceptions of undergraduates at the beginning and end of the physical therapy program at UFMG and physical therapists. The conceptions (definitions, causal attributions, solutions, and moral judgments) of disability were evaluated according to the three main disability models presented by Shakespeare (2006): the medical model, the social model, and the social-relational, or bio-psycho-social, model; whereas the attitudes were evaluated according to Antonak and Livenh (2000), considering emotions, thoughts, and behaviors. The study included a total of 42 volunteers aged 18 to 40 years old, with a balanced proportion of men and women. The participants were selected according to their level of academic training and by convenience. The participants signed the Informed Consent Form and the Voice Recording Authorization Form. The study was carried out at the School of Physical Education, Physiotherapy and Occupational Therapy in the Universidade Federal de Minas Gerais (UFMG). The results showed, through the chi-square test, a significant influence of the level of training on the distribution of frequencies between the subcategories of conceptions and attitudes. The goodness of fit test revealed significant frequency differences between the groups, except in relation to the definitions and causal attributions regarding the social and medical models, the social-relational solutions, the negative moral judgments, and positive and negative thoughts. The content analysis results showed the prevalence of negative thoughts regarding disability in all focus groups, which were frequently ableist. In relation to emotions and behaviors, they were mostly negative amongst students at the beginning and the end of the program, while amongst physical therapists the emotions were balanced and the behaviors were mostly positive. In relation to definitions and causal attributions, in all groups they were mostly from the medical model of disability, whereas the solutions were of a social-relational character and the moral judgments were negative. This study cannot affirm that training in physical therapy is the main reason for the differences and similarities found. It was possible to find recurrences and distinctions between different levels of training. In general, results of this study are important because they reveal how necessary it is to implement disability studies within the academic training for physical therapists. Physical therapists should know the history of disability, its explanatory models, and the fight of people with disabilities for their rights, in order to increase their understanding and awareness about the many conceptions of disability, so that they can critically analyze the International Classification of Functioning, Disability and Health (ICF) reflect more deeply about attitudinal barriers.