Perspectives of expert physical therapists on the international classification of functioning, disability and health (ICF): a Q study.

Abstract

Physiotherapists' varied interpretations of the International Classification of Functioning and Health (ICF) and the biopsychosocial model underlying it can significantly influence its dissemination, assimilation, and application. This study analyzed the diverse discourses of Brazilian physiotherapists engaged in teaching and researching the ICF. This descriptive cross-sectional study employed Q methodology to explore participants' viewpoints. Participants ranked diverse statements about the ICF into nine categories from "strongly disagree" (-4) to "strongly agree" (+4). Rankings were analyzed through factor analysis to identify emerging factors, then interpreted as viewpoints based on the average ranking of statements within each factor. A total of 48 experts ranked 59 statements. Participants had diverse specialties, with an average of 19.1 years of professional experience, 13.62 years of teaching, and 16.04 years of engagement with the ICF. Most were affiliated with public universities and held doctoral degrees. Factor analysis revealed two distinct viewpoints, both supporting a biopsychosocial understanding of functionality, emphasizing the ICF's value in either pragmatic or conceptual terms. The two viewpoints by experts emphasize the practical and theoretical value of the ICF, reinforcing its biopsychosocial approach to functioning.