Rebolledo Sanhueza JA1, Besoain-Saldaña AN1, Aliaga Castillo V1, Manríquez Hizaut M1, Huepe Ortega G2
1Universidad de Chile, Departamento de Kinesiología, Santiago, Chile, 2Universidad de Chile, Departamento de Bioética y Humanidades Médicas, Santiago, Chile
Background: Community Based Rehabilitation (CBR) must stimulate the autonomy of persons with disabilities (PwD), for this purpose it must develop a joint work with the family and allow the transition from “care” to “personal assistance”, to actively manage the personal assistance needed to live their lives with self-determination and dignity.
Conceptually, dependence can be understood as a specific situation of disability that entails a limitation to perform a certain activity and a context in which the interaction requires personal or technical help. On the other hand, autonomy is understood as the ability to decide and self-determine one´s life.
In the process of rehabilitation and care practices, they tend to focus on functional independence, making invisible the impact of the disability situation on the autonomy of people. In everyday life, the concepts of dependency and autonomy tend to come together, confusing the ability to do with the ability to decide.
The rehabilitation team, especially physical therapists, can support PwD and their families in dependency management through of promotion of the personal autonomy in care practices, thereby, to move from the figure of caregiver to personal assistant, from a focus of human rights.
Purpose: Analyze the role of the physical therapist in the promotion of the personal autonomy of persons with disabilities participating in Community-Based Rehabilitation in Chile.
Methods: Qualitative, exploratory and transversal study. The production of data was done through group interviews; eight with people with disabilities, five with family members and four with rehabilitation professionals. Qualitative content analysis of thematic type was used. Triangulation processes of researchers and participants were developed, validation with participants, ensuring credibility and transferability.
Results: From the experiences of the participants, physical rehabilitation to reduce dependency, with the caregiver family occupying a key role, who modifies the care practices and supports the recovery of the functional capacity of the person with disability in a collaborative work with the rehabilitation team, especially physical therapist.
However, this alliance does not always support the promotion of autonomy. The intervention of the professional can generate situations in which caregiver make decisions about life of the person with disability without their consideration, or ignore them. The above, leads to situations of loss of autonomy of both people with disabilities and their caregivers, including their overload.
Conclusion(s): Physical rehabilitation is successful in supporting independence, however it does not consider tension between autonomy and dependence present in the relationship between family caregiver and person with disability. Meanwhile PwD lose selfdetermination, caregiver use to be overload and family dynamics breakdown.
Implications: It is necessary to promote autonomy and functional independence in the process of rehabilitation and support the transition to personal assistance, managed by the person with disability, avoiding the overload of a family caregiver. It is mandatory to improve strategies of rehabilitation teams in family dynamics, and thus support the process of acceptance and adaptation of families in the face of a disability situation.
Keywords: Personal Autonomy, Disability, Community-Based Rehabilitation
Funding acknowledgements: This study (FONIS SA15I20121) was funded by the National Commission of Science and Technology (CONICYT)
Conceptually, dependence can be understood as a specific situation of disability that entails a limitation to perform a certain activity and a context in which the interaction requires personal or technical help. On the other hand, autonomy is understood as the ability to decide and self-determine one´s life.
In the process of rehabilitation and care practices, they tend to focus on functional independence, making invisible the impact of the disability situation on the autonomy of people. In everyday life, the concepts of dependency and autonomy tend to come together, confusing the ability to do with the ability to decide.
The rehabilitation team, especially physical therapists, can support PwD and their families in dependency management through of promotion of the personal autonomy in care practices, thereby, to move from the figure of caregiver to personal assistant, from a focus of human rights.
Purpose: Analyze the role of the physical therapist in the promotion of the personal autonomy of persons with disabilities participating in Community-Based Rehabilitation in Chile.
Methods: Qualitative, exploratory and transversal study. The production of data was done through group interviews; eight with people with disabilities, five with family members and four with rehabilitation professionals. Qualitative content analysis of thematic type was used. Triangulation processes of researchers and participants were developed, validation with participants, ensuring credibility and transferability.
Results: From the experiences of the participants, physical rehabilitation to reduce dependency, with the caregiver family occupying a key role, who modifies the care practices and supports the recovery of the functional capacity of the person with disability in a collaborative work with the rehabilitation team, especially physical therapist.
However, this alliance does not always support the promotion of autonomy. The intervention of the professional can generate situations in which caregiver make decisions about life of the person with disability without their consideration, or ignore them. The above, leads to situations of loss of autonomy of both people with disabilities and their caregivers, including their overload.
Conclusion(s): Physical rehabilitation is successful in supporting independence, however it does not consider tension between autonomy and dependence present in the relationship between family caregiver and person with disability. Meanwhile PwD lose selfdetermination, caregiver use to be overload and family dynamics breakdown.
Implications: It is necessary to promote autonomy and functional independence in the process of rehabilitation and support the transition to personal assistance, managed by the person with disability, avoiding the overload of a family caregiver. It is mandatory to improve strategies of rehabilitation teams in family dynamics, and thus support the process of acceptance and adaptation of families in the face of a disability situation.
Keywords: Personal Autonomy, Disability, Community-Based Rehabilitation
Funding acknowledgements: This study (FONIS SA15I20121) was funded by the National Commission of Science and Technology (CONICYT)
Topic: Disability & rehabilitation; Primary health care
Ethics approval required: Yes
Institution: Facultad de Medicina Universidad de Chile
Ethics committee: Comité de ética en Investigación con Seres Humanos
Ethics number: 169-2015
All authors, affiliations and abstracts have been published as submitted.
