The language of percentages: ranking bodies, shaping realities, and limiting opportunities

Abstract

Purpose: This exploratory study is situated in a critical tradition. It aims to describe and analyse the reliance on percentage assessments of functional capacity among a group of young adults in rehabilitation after serious motor vehicle accidents.

Methods: Qualitative interviews and participant observation. Thematic and theoretically informed analysis was carried out.

Results: The concept of percentages played a significant role in the study participants’ meaning-making processes as they went through rehabilitation. Percentage scores below 100 made a strong impression on them and were associated with strong emotions. They also strove to prove their scores wrong, often by attempting to function in full time (100%) employment positions. Significantly, many talked as if they “were” their percentage scores.

Conclusions: The utility of percentage logics is to describe parts of that which is full and whole, and we argue that this logic provides for specific and problematic ways of seeing and understanding impairment and disability. When scored on hierarchical scales, functional tests by necessity rank bodies and bodily functions as better or worse while precluding alternative understandings of affected function.

Implications for rehabilitation

• Measurements expressed in numbers and percentages are used in rehabilitation by professionals to depict and convey functional capacities to patients, but this “language” also leaks into the wider context of patients’ lives and understandings of themselves.

• The act of measurement may work to rank bodies in specific and normative ways that are unable to express difference as a valuable instance of human diversity, and may make rehabilitees question whether they are complete human beings.

• Medical professionals should address and take into consideration the wider consequences of the act of measurement when they provide guidance and support for patients’ in their rehabilitation processes.

Keywords:

• Functional testing
• normality
• patient experiences
• rehabilitation
• young adults
• work

Acknowledgements

We would like to thank the anonymous reviewers for valuable comments to an earlier version of the manuscript.

Disclosure statement

The authors declare no conflicts of interest.

Additional information

Funding

Thanks to The Norwegian Extra Foundation for Health and Rehabilitation for funding, and to the Norwegian Council for Road Safety for its role in administering the grant.