Textbook of Medical-Surgical Nursing 3e

214

Unit 3   Applying concepts from the nursing process

Case Study Disability and quality of life

CHART 10-4

‘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.’

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: 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 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. Models of disability CHART 10-5

Brian Fitzpatrick won the Doubles Tournament at the 2009 Victorian Open Wheelchair Tennis Championships.

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 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).