Phenomenology: a powerful tool for patient-centered rehabilitation (original) (raw)
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Phenomenology and Disability Studies
Springer Encyclopedia of Phenomenology
This essay introduces the field of disability studies to readers of phenomenology and highlights areas where both enterprises can benefit from theoretical engagement with each other. I begin by introducing the origins of disability studies and the field’s rejection of biomedical approaches to disability. I then review some sociopolitical interpretations of disability elaborated in response to the medical model. By reframing disability in social terms, these accounts interrogate the relationship between material embodiment and the social construction of normalcy. Phenomenology also dispenses with a view of disability as biological fact and studies disability, instead, from the perspective of being in the world. The phenomenological model of disability foregrounds the spatiotemporal, affective, sensory, and intercorporeal dimensions of disability. This descriptive enterprise yields important insights about the ways in which disabled embodiment is lived and challenges putatively universal accounts of bodily intentionality, intersubjectivity, perceptual behavior, and temporal and spatial awareness. But phenomenology’s encounter with disability does not end here. A meaningful engagement with disability must involve a critical assessment of the potential and limits of phenomenology itself. For this, phenomenology’s tools must be disoriented. I submit that a phenomenology of disability is most fruitfully realized through the disorientations of crip phenomenology.
Phenomenology and Physiotherapy: Meaning in Research and Practice
Background: Phenomenological research has emerged as an important qualitative research methodology in health care, contributing to a comprehensive approach to evidence-informed practice among healthcare professionals. Evidence-informed practice in physiotherapy will benefit from integrating phenomenological research in order to attend to the lived-experiences of both clients and therapists involved in physiotherapist-client encounters, building a more sensitive and holistic approach to physiotherapy practice.
How to develop a phenomenological model of disability
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Disability and rehabilitation, 2007
Aims. It is a generally shared opinion that rehabilitation is not (yet) 'fully person-centred' and that it should be more. For a certain number of authors, this deficit in person-centredness has originated from the important weight of a 'medical framework' within rehabilitation. In this paper, we will discuss this criticism and its corollary: the idea that rehabilitation is bound to choose between a non-medical and a medical paradigm, since there is a fundamental contradiction between medicine and person-centredness. In the first section of the paper, we will examine the conceptual history of rehabilitation and question whether this history can really be summarized as a 'shift from a medical approach to a person-centred approach'. In the second section, we will question assumptions and suggestions that have been made to develop personcentredness in rehabilitation. In the third section, we will discuss what might be gained but also what might be lost by reinforcing person-centredness in rehabilitation. Key findings and implications. (i) The history of rehabilitation is complex with several stages and paradigm shifts. Furthermore, these paradigms do not succeed one another but overlap. It would therefore be erroneous to reduce the history of rehabilitation to merely a shift 'from a medical approach to a person-centred approach'. (ii) Several proposals of how to make rehabilitation more person-centred are found within the literature. However, none of these appears satisfactory with each leading to theoretical and practical difficulties. (iii) Although person-centredness has unquestionably contributed to the overall progress of rehabilitation, it is not certain that more person-centredness is the solution to current challenges to rehabilitation. Conclusion and recommendations. In some ways, the challenge rehabilitation faces is the need to transpose and adapt a notion (person-centredness) that has emerged from fields that are in fact unrelated to disability such as, for example, clinical psychology. The difficulties encountered are therefore not so much related to the particular dominance of a 'medical model' in rehabilitation than they are to the complexities of the concept of disability. We argue that one way forward might be to clarify further the respective role of the medical and non-medical aspects of rehabilitation in ways that go beyond what has been already achieved in either the ICIDH or ICF but which is still unsatisfactory or incomplete in many respects.
Clara: A Phenomenology of Disability
American Journal of Occupational Therapy, 2003
A phenomenological approach was used to describe the lived experience of disability of a woman who sustained a head injury 21 years ago. Data were collected through 11 face-to-face interviews and 72 e-mail messages over the period of 11 weeks. An iterative, fluid process of questioning, information-giving, analysis, and verification was characteristic of the whole study, alternating between analysis of the particular and analysis of the general. Through a process of phenomenological reduction, each interview transcript and e-mail message was divided into meaning units that denoted shifts of meaning. Similar meaning units within a transcript or message were then grouped and summarized in a phrase or word. As new meaning units emerged, additional interviews and e-mail exchanges took place in order to obtain an exhaustive description of the experience of disability. All meaning units obtained from this iterative process finally were “horizonalized” into meaning clusters of nonrepetitiv...
People experiencing disability and chronic disease often feel powerless, relinquishing medical control to “more knowledgeable” professionals. This article presents qualitative and quantitative results from three individual patients experiencing an emerging procedure called Recovery Preference Exploration (RPE). To inspire greater patient involvement, self-direction, and individual choice, we instructed participants to create an imagined recovery path, exposing recovery preferences while learning about clinical rehabilitation concepts. Results uncovered important values and feelings about disability, providing a richer context for patient evaluation and treatment goal modification. Applying mixed methods, RPE is presented as an explanatory process for quantifying recovery preferences in a way that stimulates rich narrative of how people see different types of disabilities. RPE shows promise for increasing depth of discussions among patients, family, and clinicians. RPE may promote greater quality of life through patient empowerment by directed learning, increased communication, and enhanced self-knowledge.
Medical phenomenology and stroke rehabilitation. An introduction.
This issue of Topics in Stroke Rehabilitation explores the theme of medical phenomenology and stroke rehabilitation through open peer commentary format. The theme is introduced by a brief summary and overview of phenomenology as a branch of philosophy whose focus is the development of methodology for describing and ordering human experience. The application of this philosophical approach to medicine in general and stroke rehabilitation in particular is then considered. An approach to patients informed by both phenomenology and science provides a more complete, holistic, and humanistic framework than science alone. Phenomenology helps the clinician to understand the importance of narrative, the process of adaptation at the level of the integrated whole person, and the important role of context in determining how recovery unfolds. Embodiment is presented as an organizing principle that links the nature of conscious experience in the lived body and the basic transformation in experience and function associated with an acquired pathology such as stroke. Finally, the nature of open peer commentary is considered and introduced in terms of how it has been specifically implemented in this issue of Topics in Stroke Rehabilitation.