The Egyptian physiotherapist journey to emancipation: a grounded theory study

Autonomy is considered the most determinist feature of professions that distinguish their identity from occupations and para-professions. The literature revealed no information about the autonomy of physiotherapists in Egypt, which raised questions about how physiotherapy is perceived as a profession. The purpose of this study was to explore the identity of Egyptian physiotherapy from the perceptions of physiotherapists, patients and physicians. A total of 74 participants were interviewed in Arabic individually or in focus groups. Participants included 32 physiotherapists, 26 physicians and 16 patients. The data was collected and analysed according to constructivist grounded theory methodology. The findings suggest that most participants perceived Egyptian physiotherapy as a para-profession undertaking a process of professionalisation. However, during undergraduate education, physiotherapists developed expectations of autonomy in a work culture where physiotherapy would be fully professionalised. Yet, the most prevailing working culture was one where physiotherapists had no autonomy, and the content of their work was dictated by physiatrists. This culture jarred with the physiotherapist's individual professional identity. The grounded theory constructed posits that the Egyptian physiotherapist's professional identity underwent a continuous process of development and change throughout their academic and career experiences. This process consisted of 3 stages. 'Constructing' occurred during undergraduate education where physiotherapists formed their nascent professional identity as doctors of physiotherapy. 'Struggling' happened as physiotherapists transitioned into an incompatible employment scenario. The struggle involved both internal struggles with role conflict, and external power struggles with physiatrists to gain autonomy. 'Emancipating' occurred through self-empowerment using continuous professional development and self-reflection that enabled professional identity transformation in a way helped physiotherapists to change the culture in the workplace. Successful transformation of professional identity required forming a community of practice that supported personal and professional growth and harnessed the collective efforts of physiotherapists to forge collaborative relationships with physiatrists.