Besoain-Saldaña A1,2, Rebolledo J1,2, Manriquez M1, Huepe Ortega G3, Aliaga V1,2
1University of Chile, Departamento de Kinesiología, Santiago, Chile, 2University of Chile, Núcleo en Desarrollo Inclusivo, Santiago, Chile, 3University of Chile, Departamento de Bioética y Humanidades Médicas, Santiago, Chile
Background: Worldwide disability prevalence has been established around 15%. Meanwhile, Chile has a national prevalence of 16,7%, 20.3% for women and 12.9% for men. Gender bias in health has been identificated, specially in access, counselling, assessment, and treatment in primary and specialty care. Community-based rehabilitation (CBR) is a worldwide strategy aimed to assure equal opportunities and social inclusion of men and women with disabilities, thus intersectional perspectives in rehabilitation are crucial for improving needs, behaviour and expectations in rehabilitations of people with disabilities.
Purpose: To compare gender differences in perceptions, expectation and experiences about social inclusion and disability of men and women with physical disabilities in Chile.
Methods: A qualitative, interpretive and analytic study was performed. Data production was thorough 9 grupal interview (4 with men and 4 with women) in CBR centers in primary health care of Metropolitan district of Chile. Data analysis was based in grounded theory principles, constant comparison method and achieving saturation of analytic proposed and emerging categories. Data Triangulation, Data validation by participants and detailed method description were performed, improving credibility and transferability. Approved by ethic comitte, School of medicine, Universidad de Chile.
Results: 4 groupal interviews were performed, including 22 men (46-79 years old, mainly parkinson disease and stroke) and 28 women (28 - 86 years old, mainly osteoarthritis, stroke and differential diagnosis). Gender difference were grouped in four fields:
a) Social Role: Social role of women were dual, related to housekeeping and job, meanwhile men focused their role in productive y job related tasks;
b) Health needs: women declared barriers of accessibility and stigma for access for sexual and reproductive rights;
c) Strategies for disability acceptance: Women established familiar and communitarian networks for self-support and assistance in daily living activities, meanwhile men narrated their rehabilitation process from exercise, obediences and dependence from health care personnel. Both gender established that acceptance of disability changes life style and expectations, nonetheless they concluded that disability provided them a change and rethink their lives.Mental health is recognized as a health need that is not satisfied in CBR.
Conclusion(s): Gender differences between men and women with disabilities in perceptions, expectation and experiences about social inclusion and disability of men and women with physical disabilities are related to health needs, social roles and gender behavior, setting more isolation risk for men than women. Cultural and physical are recognized as barries for social inclusion, both men and women.
Implications: Graduate and professional training in intersectionality between gender and disability, is an opportunity to improve integrality and quality of community-based rehabilitation. Establishing gender-based strategies in prevention, promotion and rehabilitation in CBR, could enhance autonomy and social cohesion, especially in men, who used to have self-sufficency patterns of relationship with their communities. Including Social Determinants of Health in communitarian work of physiotherapy is a need for improve health needs comprehension, managment and satisfaction.
Keywords: Primary health Care, Disability, Gender
Funding acknowledgements: This study (FONIS SA15I20121) was funded by the National Commission of Science and Technology (CONICYT)
Purpose: To compare gender differences in perceptions, expectation and experiences about social inclusion and disability of men and women with physical disabilities in Chile.
Methods: A qualitative, interpretive and analytic study was performed. Data production was thorough 9 grupal interview (4 with men and 4 with women) in CBR centers in primary health care of Metropolitan district of Chile. Data analysis was based in grounded theory principles, constant comparison method and achieving saturation of analytic proposed and emerging categories. Data Triangulation, Data validation by participants and detailed method description were performed, improving credibility and transferability. Approved by ethic comitte, School of medicine, Universidad de Chile.
Results: 4 groupal interviews were performed, including 22 men (46-79 years old, mainly parkinson disease and stroke) and 28 women (28 - 86 years old, mainly osteoarthritis, stroke and differential diagnosis). Gender difference were grouped in four fields:
a) Social Role: Social role of women were dual, related to housekeeping and job, meanwhile men focused their role in productive y job related tasks;
b) Health needs: women declared barriers of accessibility and stigma for access for sexual and reproductive rights;
c) Strategies for disability acceptance: Women established familiar and communitarian networks for self-support and assistance in daily living activities, meanwhile men narrated their rehabilitation process from exercise, obediences and dependence from health care personnel. Both gender established that acceptance of disability changes life style and expectations, nonetheless they concluded that disability provided them a change and rethink their lives.Mental health is recognized as a health need that is not satisfied in CBR.
Conclusion(s): Gender differences between men and women with disabilities in perceptions, expectation and experiences about social inclusion and disability of men and women with physical disabilities are related to health needs, social roles and gender behavior, setting more isolation risk for men than women. Cultural and physical are recognized as barries for social inclusion, both men and women.
Implications: Graduate and professional training in intersectionality between gender and disability, is an opportunity to improve integrality and quality of community-based rehabilitation. Establishing gender-based strategies in prevention, promotion and rehabilitation in CBR, could enhance autonomy and social cohesion, especially in men, who used to have self-sufficency patterns of relationship with their communities. Including Social Determinants of Health in communitarian work of physiotherapy is a need for improve health needs comprehension, managment and satisfaction.
Keywords: Primary health Care, Disability, Gender
Funding acknowledgements: This study (FONIS SA15I20121) was funded by the National Commission of Science and Technology (CONICYT)
Topic: Disability & rehabilitation; Health promotion & wellbeing/healthy ageing; Primary health care
Ethics approval required: Yes
Institution: School fo medicine, University of Chile
Ethics committee: Comité de ética en investigación en seres humanos
Ethics number: 169-2015
All authors, affiliations and abstracts have been published as submitted.
