1. Background
Disability is part of being human. Every person may experience temporary or permanent disability at some point. According to the World Health Organization (WHO), disability has been described as a complex phenomenon that reflects the interaction between a person's physical characteristics and the characteristics of the society in which the individual with disability lives. Disability is a complex set of conditions created by society for individuals with a disability (1, 2). The social model influences this definition. The social model was created in response to the limitations of the medical model and following the movement of British individuals with disability in the 1960s and 1970s (3).
According to the social model, it is the society that creates limitations for people with disabilities, and therefore, it is a useful solution that can lead to the elimination of these restrictions (4). This model, which states that disability is a social and political construct characterized by systemic barriers, has been widely accepted, exemplified by the slow but steady progress in providing civil rights to persons with disabilities (5). Following the emergence of this model, the concept of emancipation in the field of disability was first expressed by Oliver (6). He describes the social model as a tool to improve people's lives (7). Hughes and Paterson (1997) express the social model as a sufficient theoretical basis for emancipatory politics (8).
Wittmann-Price describes emancipation as a process in which he reaches a more positive state of being, a state of relative freedom to choose by accepting emotional experiences of oppression. This experience is reflected cognitively, with or without dialogue (9). Mazurek and Winzer see emancipation as synonymous with freedom, and it is defined as a process in which a person tries to realize his abilities and uses his rights with the utmost seriousness and perseverance to make a positive change in his life (10). In Merriam-Webster Online, emancipation is defined as free from the constraints of control and the power of others, free from parental care and responsibility, and regardless of any controlling force (11). Studies show that emancipation helps people have a better life, social participation, and empowerment (12, 13). Islamic law also supports the concept of emancipation, including the right to marry and the request for freedom (12).
The first step to achieving freedom for people with disabilities is understanding their opportunities for emancipation. Emancipation is a process that occurs within the individual and depends on people understanding what they need to do to achieve it (14). To encourage individuals with disabilities to act in the direction of the emancipation process, they must have a good understanding of the consequences of the emancipation process. Studies show that although emancipation as a process is formed in a psychosocial interaction between individuals with disabilities and society and plays an important role in the quality of life and creating an independent life for people with disabilities, this concept has not yet been explored in Iran and the world and its various aspects are not fully understood (9, 14-16). On the other hand, studies in this field are based on social participation and the factors affecting it, and there is little knowledge about emancipation and its consequences. This study's main research question is, "What are the consequences of the emancipation process in people with physical disabilities?" To answer this question, qualitative research, an appropriate method, was identified because this study's purpose is to describe the consequences of the emancipation phenomenon better, and qualitative research is done when the researcher seeks to discover variables instead of testing them.
2. Objectives
The purpose of this study is to explore the consequences of the emancipation process in individuals with physical disabilities.
3. Methods
3.1. Research Design
This study was conducted using the grounded theory method and was performed from October 2019 to October 2020. Gibbs (2009) states that social phenomena should be studied in their real environment and context, and for this reason, qualitative methods are more useful in this field (17).
Qualitative research seems to have a more effective role in clarifying ambiguity and unclear (18). The process of emancipation is based on the perception of people with disabilities from social interactions, and the grounded theory qualitative method is suitable to research to understand and recognize this phenomenon in its natural environment and social context. Our knowledge of the emancipation process in people with physical disabilities is limited, and grounded theory is the best way to conduct explanatory research on phenomena (19, 20).
3.2. Participants
The main participants included people over 18 years of age with physical disabilities who could communicate verbally. Also, they were known as successful people in society and were willing to participate in the study. Other participants were selected by random sampling based on the extracted data. Participants included 23 people with physical disabilities, a welfare organization manager, a welfare organization employee, a rehabilitation nurse, a physician, and two family members. Participants were selected with maximum diversity of gender, experience, duration of disability, and field of activity. The exclusion criteria were unwillingness to participate in the interview. In this research, the participants' most important feature had life experience, knowledge, and familiarity with the desired phenomenon, and this was the reason for choosing professionals; the participants were selected from people with physical disabilities in Tehran and Zanjan in Iran. The main reasons for selecting these cities were their accessibility, the high number of people with disabilities, and active social participation.
3.3. Data Collection
Individual interviews and two focus group interviews were used to collect data in this study. The duration of group discussions was 90 minutes and 85 minutes, respectively. The interviews were audio-taped and then transcribed verbatim immediately. After obtaining informed consent, the interviews were conducted in a calm environment and at a suitable time and place where the participants felt comfortable. Interviews started with open questions like "Are you a successful and prominent person in society? Can you explain to me the experiences you have had in this field?" By designing in-depth and follow-up questions (please give an example, in this case, explain more in this case) at the appropriate time, the researchers advanced the interview toward clarifying the phenomenon. In addition to the experiences of people with physical disabilities, guidelines for disability and related laws in the field of rehabilitation in Iran and the world were examined. The study continued until data saturation occurred.
3.4. Data Analysis
Data were analyzed using the proposed model of Corbin and Strauss (21). Data analysis followed by coding started after the first interview because the initial data was the basis for data collection and further analysis. Three stages of open, central, and selective coding were done. In open coding, the primary meanings of the participants’ sentences were extracted in the form of one sentence or several sentences or meaningful and summarized words. From the beginning of the analysis, memos were used to clarify the researcher’s interpretation of the given code or hidden ideas in the study. In the second stage, the primary codes were compared, and the category that was conceptually similar were integrated and formed the core category. The last step is combining or integrating the categories. An example of coding is given in Table 1. By repeatedly and accurately studying the text of the interviews, they were analyzed. This way, all possible findings, and meanings were considered, and appropriate conceptual labels were given to the data.
Table 1.Examples of Meaning Units, Condensed Meaning Units, and Codes
| Meaning Unit | Condensed Meaning Units | Code | Subcategory |
|---|---|---|---|
| Before this, I felt empty, and I had no sense of life, now I think my life has meaning and purpose (Participant 1)". | Before felt empty and had no sense of life, now meaning and purposeful life | A sense of meaning | Self-actualization |
Lincoln and Guba’s criteria were used to check the rigor of the data (22). In order to evaluate the credibility of the data, the extracted codes were checked by some participants and modified if necessary. The researchers had a prolonged engagement, and it took about two years to collect and analyze the data. For the purpose of assessing the confirmability of the interview texts, the codes and categories were reviewed and approved by the authors and two faculty members who were not members of the research team. To confirm dependability, the research steps were carefully recorded in detail. To achieve acceptability and transferability, participants were selected with maximum diversity.
3.5. Ethical Considerations
The study protocol was approved by the Ethics Committee of the University of Social Welfare and Rehabilitation Sciences (code: No. IR.USWR.REC.1396.196). Ethical considerations and volunteers' right to withdraw from the study were considered in this research. The interview started with no reference to the interviewee's name, and the participants were assured of the confidentiality of their identities in the publication of the results.
4. Results
The demographic characteristics of the participants are summarized in Tables 2 and 3. Initially, 3768 initial codes were created after encoding all the interviews, which were reviewed several times using experts' opinions. After reducing deletions and mergers, the number of codes was reduced to 833 codes in different stages. These codes were eventually placed in three main themes and seven sub-themes (Table 4). This study demonstrated that emancipation process results in people with disabilities developing abilities that lead to improved performance and personal growth. Behaviors and insights created following the emancipation process lead to personal excellence and growth, self-actualization, and self-determination for people with physical disabilities. In addition, the emancipation process promoted individual performance and improved social relationships. Improving the living conditions and employment of a person with a physical disability and contributing to the growth and prosperity of society were other consequences of emancipation. On the other hand, emancipating the ground for more participation of people with disabilities in society and this issue leads to more acceptance of society for them. "Excellence and growth," "functional health," and "disabled friendly community" were the main themes of emancipation consequences in people with physical disabilities.
Table 2.Demographic Data of Participants in Individual Interviews (N=18)
| No | Gender | Age | Education | Residential Place | Cause of Disability | Field of activity | Level of Disability | No. Interviews | Interview Duration |
|---|---|---|---|---|---|---|---|---|---|
| P 1 | Male | 26 | Bachelor | Zanjan | Congenital | Athlete | Paraplegia | 1 | 45 |
| P 2 | Male | 45 | Associate degree | Zanjan | Poliomyelitis | Coach | Paraplegia | 2 | 90 |
| P 3 | Female | 38 | PhD | Tehran | Poliomyelitis | University professor | Paraplegia | 1 | 70 |
| P 4 | Male | 43 | Diploma | Tehran | Car accident | Craftsman | Paraplegia | 1 | 65 |
| P 5 | Male | 27 | Master student | Zanjan | Congenital | Athlete | Paraplegia | 1 | 50 |
| P 6 | Female | 26 | Master student | Tehran | Car accident | Athlete | Hemiplegia | 1 | 40 |
| P 7 | Male | 33 | Master | Zanjan | Burn | Entrepreneur | Paraplegia | 1 | 80 |
| P 8 | Male | 33 | Bachelor | Tehran | Congenital | inventor | Paraplegia | 1 | 75 |
| P 9 | Male | 56 | Bachelor | Zanjan | Maternal injury | Craftsman | Paraplegia | 1 | 60 |
| P 10 | Female | 35 | Doctor of medicine | Zanjan | Poliomyelitis | Physician | Parapraxis | 1 | 50 |
| P 11 | Female | 30 | Bachelor | Tehran | Car accident | Athlete | Paraplegia | 1 | 65 |
| P 12 | Female | 28 | Master student | Tehran | Congenital | Painter | Parapraxis | 1 | 75 |
| P 13 | Male | 47 | Masters | Zanjan | - | Welfare organization manager | - | 1 | 75 |
| P 14 | Female | 44 | Bachelor | Zanjan | - | Welfare organization employee | - | 1 | 60 |
| P 15 | Female | 38 | Bachelor | Tehran | - | Nurse | - | 1 | 55 |
| P 16 | Female | 35 | Doctor of medicine | Tehran | - | Physician | - | 1 | 50 |
| P 17 | Female | 43 | Diploma | Tehran | - | Member of family | - | 1 | 80 |
| P 18 | Female | 55 | Diploma | Tehran | - | Member of family | - | 1 | 70 |
Table 3.Demographic Data of Participants in Focus Groups (N = 12)
| No | Gender | Age | Education | Cause of Disability | Field of Activity | Level of Disability | Group Number |
|---|---|---|---|---|---|---|---|
| P 19 | Male | 39 | Master | Car accident | Athlete | Paraplegia | 1 |
| P 20 | Female | 40 | Bachelor | Falling | Graphic designer | Paraplegia | 1 |
| P 21 | Male | 38 | General practitioner | Car accident | Physician | Paraplegia | 1 |
| P 22 | Male | 35 | Master | Car accident | Entrepreneur | Paraplegia | 1 |
| P 23 | Female | 43 | Master student | Falling | Athlete | Paraplegia | 1 |
| P 24 | Female | 27 | Master student | Burn | Athlete | Hemiplegia | 2 |
| P 25 | Male | 36 | Associate | Brain tumor | Craftsman | Paraplegia | 2 |
| P 26 | Male | 33 | Bachelor | Congenital | Inventor | Paraplegia | 2 |
| P 27 | Male | 56 | Bachelor | Maternal injury | Craftsman | Paraplegia | 2 |
| P 28 | Female | 35 | Doctor of medicine | Poliomyelitis | Physician | Parapraxis | 2 |
| P 29 | Female | 30 | Bachelor | Car accident | Athlete | Paraplegia | 2 |
Table 4.Main Themes and Subthemes Consequences of the Emancipation Process in the Individual with a Physical Disability
| Category and Subcategory | Code |
|---|---|
| Excellence and growth | |
| Self-actualization | A sense of meaning; Feeling effective; Realism; Self-esteem; self-confidence; merit |
| Self-determination | Making decisions based on interests; increasing motivation to accept responsibility; setting goals; planning to achieve goals |
| Functional health | |
| Improving personal performance | Self-reliance and independence; Improving physical health; Spiritual self-care; Life satisfaction; Increasing life expectancy (optimism with striving for progress) |
| Economic self-sufficiency | Financial independence; support the family; Creating entrepreneurial opportunities |
| Improving social relationships | Ability to communicate purposefully with other people; satisfactory communication with family; Facilitation in marriage; A sense of security in interpersonal relationships; Increasing awareness of individual and social rights; Increasing the sense of belonging to the community |
| Disabled friendly community | |
| Cultural acceptance of disability | Promotion of social trust; social acceptance; Promoting disabled-friendly culture; Changing the attitude of policymakers |
| Social participation | Production and prosperity of society; Reducing the burden of disability |
4.1. Excellence and Growth
They saw this emancipation consequence as a miracle they sought outside of themselves and achieved within. Participants believed that personal growth is, in fact, more than anything else, about human investment in oneself so that one can manage oneself regardless of any obstacles in life. In other words, instead of waiting for good things to happen in his life, the person himself becomes the cause of these happenings. This theme itself includes the subthemes of self-actualization and self-determination.
4.1.1. Self-actualization
Most participants described the flourishing of their talents and sense of meaning as an important consequence of emancipation. This sense of meaning has given them a sense of effectiveness, competence, and usefulness. This helped them to realistically look at their abilities and limitations and use these abilities to achieve success and competencies.
"Before I felt empty, I didn't have a sense of life, and now I think my life has a purpose" (p 6).
Participants stated that after emancipation, the person reaches a sense of self-worth, which leads to acceptance of responsibility in the family and society and an increase in people's self-confidence. Emancipation has also led to career and academic success. For example, a physical individual with a disability who won the Buccia International Championships said, "I was never disappointed like a mountain. I failed several times, but in the end, I succeeded".
4.1.2. Self-determination
One of the most important consequences expressed in this study is that the participants obtained the right to self-determination after realizing emancipation. The participants stated that a person realizes he has the right to choose and make decisions based on his interests and to plan and try to achieve his hopes, dreams, and goals. Also, following emancipation, the motivation to accept responsibility for the decisions they make has increased in them. This responsibility seeks to set goals and plan to achieve these goals, which leads to accepting the consequences and effects of the decisions made by them. A participant had a statement in this regard.
"When I have decided to do something myself, I accept it if it doesn't work well (P 27)".
4.2. Functional Health
The participants believed that letting go leads to improved performance in both personal and social dimensions. They stated that following the liberation of a person, he reaches self-care in physical, mental, and psychological dimensions, and this issue leads to independence in him. Participants stated that a person who achieves discharge accepts and takes responsibility for his care. This category includes two subcategories: "Improving personal performance," "Economic self-sufficiency," and "Improving social relationships."
4.2.1. Improving Personal Performance
The individual with a disability who has been emancipated is no longer dependent on others as before, and the concept of self-care has been realized in him. This independence affects a person's physical and mental dimensions.
"I follow my diet, I quit smoking, and I don't do anything to harm my body (p 8).
Participants were self-reliant. Self-reliance makes them feel capable and self-efficacious, and self-efficacy also increases self-confidence and the spirit of endurance and stability. All these factors lead to free-building efforts that ultimately satisfy them. Mental and spiritual self-care was another consequence expressed by the participants. They stated that they have become kind to themselves after being active and emancipation and are doing their best to have a happier life. They believed that their activities have led to hope and satisfaction in their lives to achieve their goals. This satisfaction has helped them to strive with a positive attitude to achieve their goals. The participants mentioned the achievement of self-belief and increased self-confidence as one of the most important achievements of emancipation.
4.2.2. Economic Self-sufficiency
One of the most important factors for returning people with disabilities to society and providing them with an opportunity for a normal life is a suitable job, which is achieved after emancipation. They stated that a disabled person, as a human being and a citizen, has all the needs of a normal person and must meet the needs of his life. Said a participant in this regard:
"I used to take money from my father, and I was very embarrassed
That's why I have to require others at this age, but now I'm getting paid, even though I helped my dad buy a house (participant 10)."
On the other hand, not having a job limits their social communication, and they cannot be effective in changing their environment and living and social conditions, and finally, their personal and social identity and their family and society's acceptance of them are disturbed. The participants stated that emancipation is the main key to entrepreneurship. They were not only thinking about their employment but also wanted to provide employment opportunities for other people.
Sometimes their activities lead to entrepreneurship and job creation for other people with disabilities
4.2.3. Improve Social Relationships
Following the emancipation process, the ability to communicate purposefully with other people is possible, and this communication is satisfactory for them. One of the participants stated in this regard:
"Previously, wherever the family went, they went without me, but now my connection with those around my friends and me has increased (participant 3)".
These relationships also facilitate their marriage. Emancipation has also led to a sense of security in their social relationships, which has improved their relationships.
"In the past, I was afraid of being in the community, but now the situation is different; I would like to be with the others (participant 7) ". Participants also said that they have increased their attention to recognizing their rights and are working to realize them. As a result, their sense of belonging to society has increased, and they consider themselves a part of society's progress.
4.3. Disabled-Friendly Community
Emancipating is a precursor to the progress of society for the greater participation of people with disabilities. Participants believed that successful people with disabilities in society would change unconventional attitudes and move society towards a flourishing culture of accepting people with disabilities and their social participation.
4.3.1. Cultural Acceptance of Disability
The emancipation of individuals with disabilities increases society's trust in disabled people and their abilities. On the other hand, society's attitude effectively accepts the abilities of individuals with a disability. This attitude will lead to the emancipation of disabled people towards more social presence and the promotion of a friendly culture for an individual with a disability and an ideal society for them. Emancipation also leads to a change in the attitude of officials towards individuals with a disability and their talents and abilities.
"When disabled people show their talents and abilities, society feels trust in them (participant 2)".
The managers participating in this study believed that disabled people are hardworking people who can solve problems and actualize their talents. In addition, they had a positive view of disabled people and believed that the presence of more disabled people in social scenes should be provided.
“The emancipation and empowerment of people with disabilities make society aware of and trust in their abilities and talents (participant 16)”.
4.3.2. Social Participation
The individual with a disability who enters the labor market and activity not only helps himself and his family but also plays a valuable role in the production and prosperity of society. When a successful individual with a disability becomes independent, this success affects their personal life and society. Their activities contribute to the movement of the wheel of production and affect the progress of society. After emancipation, the employment opportunities of people with disabilities in society increased, and this led to a reduction in their economic burden and overhead in society.
"I was able to work. It also helped me to be independent. Well, now I have a workshop that serves. These activities affect the progress of society (participant 14).
5. Discussion
This study aimed to explore the consequences of emancipation for people with physical disabilities. Data analysis showed that emancipation is a wide-ranging issue that affects a wide range of individual and social levels over a wide range of activities of people with disabilities. At the individual level, it leads to the promotion of performance, and at the social level, it leads to the promotion of the culture of society and the social participation of the individual with a disability.
5.1. Excellence and Growth
Self-actualization was one of the implications of this study. Self-actualization expresses a person's tendency to flourish in what is potentially there. Self-actualization can be considered the product of a human desire to succeed in an activity that he believes is important and is an aspect of his activity. Participants stated that emancipation had led to their self-actualization (23). A study also showed that the social activities of people with disabilities led to their empowerment and self-actualization (24). Another study showed that people with disabilities who are successful in sports have higher self-actualization and self-worth than other people with disabilities (25), which is also mentioned in this study.
Self-determination was another positive consequence of emancipation for individuals with physical disabilities. Attention to the concept of self-determination in the field of disability has received significant attention, and it predicts their success in adulthood. Wehmeyer (2005) defined self-determination as "the voluntary action that allows a person to act as a key factor in life and maintain and improve the quality of life. Self-determined behavior refers to actions that are characterized by four basic characteristics: (1) the person acts independently; (2) the person has self-regulated behaviors; (3) the person initiates or responds to the event; (4) a person acts in a conscious way (26, 27). The present study also showed that in order to emancipate people with disabilities to achieve success, they set goals based on what they are interested in and take responsibility for achieving these goals. They plan to achieve goals consistent with the findings of other studies (28).
5.2. Functional Health
Self-reliance and independence in performance are other consequences of emancipation. Independence means having the experience of choosing and regulating behavior. An independent human being has the right to choose for herself instead of determining the events of her environment (29). A study showed that in people with disabilities, perceived independence is associated with satisfaction and competence. Also, motivation for independence and satisfaction is associated with higher well-being and psychological ability (30). The release process leads to improved self-care and performance. They stated that their physical, mental, and psychological health had improved after emancipation. They take responsibility for self-care and make every effort to maintain their health. Chiao et al. also showed that the social participation of people with disabilities leads to improved mental health (31). Poverty and disability are certainly interrelated. Both concepts may be the result of one another (32). One of the reasons could be that people do not have access to a suitable job (33). The results of the present study showed that following the emancipation of the individual, there is an opportunity for more social presence in society, providing employment and, as a result, better economic conditions. This contributes to people with disabilities in the growth and prosperity of society, which is consistent with the results of other studies (34, 35). Emancipation also improves a person's social relationships with other family members. Participants stated that they felt more satisfied and secure after emancipation in their relationships with others. They believed they were valuable, and others did not look down on them. On the other hand, this issue leads to more social support and the flourishing of talents in these people. Dastyer and Mohammadi also showed a relationship between social participation and empowerment of the physical individual with a disability (36). Müller et al.'s study also showed that social relationships and support received in this way positively affected the health and functioning of people with spinal cord injuries (37).
Emancipation facilitates employment for people with disabilities, and a job provides a sense of identity, socialization, and normality, consistent with the study's findings (38).
5.3. Disabled-Friendly Community
Moreover, the present study indicated that public confidence in individuals with disability will increase after emancipation and awareness of their abilities and talents. Studies also show that social trust is associated with the communication and social participation of people with disabilities (39).
Considering the results obtained from the study and the positive consequences that emancipation has on the individual and social life of people with physical disabilities, it is suggested that interventions that facilitate the emancipation process be considered in future studies. Satisfaction and improving the quality of life of people with disabilities require facilitating the process of emancipation and eliminating habits that have led to their dependence on others. This study showed that emancipation plays an important role in the development of people with disabilities, and policymakers should help to achieve the emancipation process by creating a supportive and encouraging atmosphere in which emancipation is valued. Policymakers and influential people in the field of disability and rehabilitation can use the findings of this study to develop and cultivate a culture of promoting emancipation in society to improve the quality of life of people with disabilities and to create a supportive atmosphere to empower and encourage these people to take action and realize their talents. Satisfaction and improving the quality of life of people with disabilities require facilitating the process of emancipation and eliminating habits that have led to their dependence on others.
5.4. Study Limitations
In this study, an attempt was made to interview in a completely calm environment; however, in some interviews, due to the proximity of the interview venue to the gym, the interviewees' attention is distracted. Also, setting the interview time, especially for athletes due to time constraints, was another limitation of this study.
5.5. Conclusions
The findings of this study indicate that people with physical disabilities are seeking emancipation and that emancipation in them has resulted in changes in their lives' social and personal dimensions. If society facilitates this process, it will reduce the burden of disability and increase the presence of disabled people. Therefore, policymakers should pay more attention to it.
