214
Unit 3
Applying concepts from the nursing process
and for the examination of how society and healthcare profes
sionals contribute to discrimination by viewing disability as an
abnormal state.
Access to healthcare
Chart 10-6 reviews specific areas of assessment when caring for
people with disabilities.
The needs of the people with disabilities in healthcare
settings present many challenges to healthcare providers:
how to communicate effectively if there are communication
deficits, the additional physical requirements for mobility,
and time required to provide assistance with self-care routines
during hospitalisation. Chart 10-7 identifies strategies to com
municate effectively with people with disabilities.
Barriers to healthcare
Healthcare, including preventive health screening, is essential
to enable people with disabilities to live the highest quality of
Case Study
Disability and quality of life
The following is an excerpt from an interview with Brian
Fitzpatrick, who was born with spina bifida. ‘I have always
loved playing tennis. As a teenager, I played tennis in weekend
competitions, even though I was born with a medical condition
called spina bifida that would eventually lead to a decline in
my leg muscle function. When the condition finally forced me
to use a wheelchair 20 years later for activities such as long
walks and some sporting activities, I began to look for a way
to continue playing competitive tennis … from my wheelchair!
‘After training with Wheelchair Sports Victoria in October
2009, I competed in my first national competition, the 2009
Victorian Open Wheelchair Tennis Championships. It was a
great experience, meeting people with all types of disabilities,
each with a very positive attitude, and who all became real
inspirations.
‘I played in the Singles and Doubles tournaments, winning
the first round of the Singles 6–0, 6–1. I went on to play the
number one player in our division in the second round. While
he was too strong for me in that game, he went on to win
the Singles final. I did, however, succeed in the Doubles
final, winning the match 6–0, 6–1. I came away with a trophy,
but more importantly with the motivation and inspiration
to continue playing. Playing tennis in a wheelchair is very
challenging but also most rewarding.
‘Equally satisfying is my recent interest in bike riding. With
the assistance of an optional motorised function, my specially
developed three-wheel bike ensures that I can continue to enjoy
sporting activities from a fitness perspective and also to share
my love of sports with my 12-year-old son, Zach.’
CHART
10-4
Brian Fitzpatrick won the Doubles Tournament at the 2009
Victorian Open Wheelchair Tennis Championships.
Models of disability
Medical model
This model equates people who are disabled with their
disabilities and views disability as a problem of the person,
directly caused by disease, trauma or other health condition,
which requires medical care provided in the form of individual
treatment by professionals. Healthcare providers, rather
than people with disabilities, are viewed as the experts or
authorities. Management of the disability is aimed at cure or
the person’s adjustment and behaviour change. The model is
viewed as promoting passivity and dependence. People with
disabilities are viewed as tragic (Goodall, 1995; WHO, 2001;
Lollar & Crews, 2003).
Rehabilitation model
The rehabilitation model emerged from the medical model.
It regards disability as a deficiency that requires a rehabilitation
specialist or other helping professional to fix the problem.
People with disabilities are often perceived as having failed if
they do not overcome the disability (Lollar & Crews, 2003).
Social model
The social model, which is also referred to as the barriers
or disability model, views disability as socially constructed
and as a political issue that is a result of social and physical
barriers in the environment. Its perspective is that disability
can be overcome by removal of these barriers (French, 1992;
Richardson, 1997; Shakespeare & Watson, 1997; WHO, 2001).
Biopsychosocial model
The biopsychosocial model integrates the medical and social
models to address perspectives of health from a biological,
individual, and social perspective (WHO, 2001). Critiques of this
model have suggested that the disabling condition, rather than
the person and the experience of the person with a disability,
remains the defining construct of the biopsychosocial model
(Lutz & Bowers, 2005).
Interface model
The interface model is based on the life experience of the
person with a disability and views disability at the intersection
(i.e., interface) of the medical diagnosis of a disability and
environmental barriers. It considers rather than ignores
the diagnosis. The person with a disability, rather than
others, defines the problems and seeks or directs solutions
(Goodall, 1995).
CHART
10-5
