Disablement Models Flashcards
1
Q
Why do we have disablement models
A
- to have a unified framework to define health & disability
- create an universal language
- help clinicians make decisions throughout the continuum of care
- help agencies make decisions/policies for providing benefits
- allows to provide customized care for individual patients
2
Q
Define a medical model
A
- attribute of person directly related to disease/condition
3
Q
Define a social model
A
- problem is created by an unaccommodating/inflexible environment due to attitudes or features of the social & physical environment
4
Q
Define a biopsychosocial model
A
- disability is viewed as a consequence of biological, personal, & social forces
5
Q
Characteristics of the medical model and disability
A
- the problem is with the person with the disability
- the disability needs to be fixed
- professionals are the only hope for cure or normality
- goals are to “over-come” or normality
6
Q
Keys points of the medical model
A
- focus only on curing the disease
- disease manifestations at all levels considered the same
- treatment results in a curing the disease, living with it, or death
7
Q
What are the 4 components of the Nagi social disablement model
A
- Pathology: disruption/injury to body tissues
- Impairment: loss/disruption of structure or function at system level
- Functional limitations: inability/decreased ability to perform activities in a normal manner
- Disability: restriction of abilities in occupational roles, family roles, recreational roles etc.
8
Q
What are the 4 components of the biopsychosocial model
A
- Disease: disruptions at the cell or tissue level
- Impairment: disruption of structure/function
- Disability: decreased ability to perform activities at person level
- Handicap: continued limitations at societal level imposed by physical environmental barriers or attitudes
9
Q
Order of a linear interactions between disablement components
A
- Pathology
- Impairment
- Functional limitation
- Disability
- Handicap
10
Q
What does IFC model stand for
A
- International classification of functioning, disability, and health
11
Q
Describe the ICF model
A
- model of enablement
- emphasis on what patient’s can do as an initial basis for devising POC
- describes a patient’s health/functional status in the context of environmental or personal factors
- gives a holistic picture of a person
12
Q
Define model of enablement
A
- use of positive terms of normal health & functioning instead of negative terms of disease, impairment, etc.
13
Q
Examples of body functions & structures impairments
A
- bones
- ligaments
- muscles
- sensation
- circulation
14
Q
Examples of activity limitations
A
- speaking
- walking
- jumping
- bed mobility
- dressing
- bathing
- eating
15
Q
Examples of participation restrictions
A
- work roles
- social roles
- athletic roles
16
Q
Examples of environmental factors
A
- Physical aspects: appropriate living/working conditions, transportation
- Social factors: financial situation, access to healthcare, support from community
- Social attitudes: expectations from others, ideas/biases about disabilities/handicap
17
Q
Examples of personal factors
A
- age
- gender
- comorbidities
- coping styles
- social background
- education
- behaviors
18
Q
Define impairments
A
- problems with body functions/structures
- deviation from the norm
- temporary or permanent
19
Q
Define activity limitations/functional limitations
A
- difficulties someone may have in executing activities and/or ADLs
20
Q
Define participation restriction
A
- problems experienced in the involvement in life situations
21
Q
Order of the patient management model
A
- Examination
- Evaluation
- Diagnosis
- Prognosis
- Intervention
- Outcomes
22
Q
Common PT diagnoses for neuro patients
A
- Movement pattern coordination deficit
- Force production deficit (fancy way of saying weakness)
- Fractionated movement deficit
- Postural vertical deficit
- Sensory selection & weighting deficit
- Sensory detection deficit
- Hypokinesia (decreased body movement)
- Dysmetria (under/over shooting movements)
- Cognitive deficit
23
Q
Factors that help determine neuro prognosis
A
- Progressive nature of pathology (non vs progressive pathology)
- Extent of pathology (focused vs broad area of injury)
- Age (younger vs older)
- Number of systems impaired/comorbidities (single/few systems vs multiple systems)
- Acuity of disorder (<6 mo vs >6 mo)
- Initial level of function (high vs low physical functioning)
- Glasgow coma scale (high vs low score)
- Sensation (intact vs absent)
- Degree or impairment (mild vs severe Sx)
- Prior intellectual (higher vs lower intelligence)
- Prior level of physical function (very active vs difficulty walking)
- Duration of amnesia ( short vs long)
- Current cognitive status (optimal vs decreased arousal, attention, cognition)
- Motivation (highly vs poorly motivated)
- Family/social support (strong vs limited)
- Recent trends of recovery (ongoing vs no recent improvements)
24
Q
What components must every goal have
A
- Audience (who)
- Behavior (what)
- Conditions (how)
- Degree (how well)
- Expected duration (by when)
25
Q
How does ICF help inform patient management
A
- diagnosis
- prognosis
- goal writing
- effective interventions
- determining D/C requirements, destinations
26
Q
What does HOAC II stand for
A
- Hypothesis oriented algorithm for clinicians II
27
Q
How does HOAC II help in patient management
A
- arrive at an appropriate diagnosis/assessment
- use current evidence to design/refine POC
- during re-evaluation to update/change POC
- better clinical justification (supports medical necessity)
28
Q
Define PIPs and NPIPs
A
- PIPs = patient identified problems (existing problems)
- NPIPs = non-patient identified problems (anticipated problems that need preventative intervention)
29
Q
Order of clinical decision making using HOAC II
A
- Generate hypotheses for each existing & anticipated problem
- Select appropriate tests/measures to test hypothesis
- Refine hypothesis based on examination outcomes
- Generate appropriate goals for each hypothesis
- Determine interventions to address hypotheses
- After interventions test each hypothesis again to assess changes in status of problem
30
Q
4 conditions in Gentile Taxonomy movement analysis of tasks
A
- Stable body in stationary environment
- Stable body in moving environment
- Body transport in stationary environment
- Body transport in moving environment
31
Q
Gentile’s taxonomy limitation
A
- it does not analyze quality of movements in terms of its essential components (movement constructs) or their timing (temporal sequence), so does not inform how a task is impaired
32
Q
Core tasks in the movement continuum framework
A
- Initial conditions
- Preparation: did patient understand instructions/task requirements
- Initiation
- Execution
- Termination
- Outcome achieved?
33
Q
Words to use to analyze initiation, execution, & termination of a movement
A
- symmetry
- speed
- amplitudee
- alignment
- postural control verticality
- stability
- coordination smoothness
- sequencing
- timing
- accuracy
- symptom production
- Stages of motor control: mobility, stability, controlled movement, skill
