Lecture 4 - Medical & Social Models of Disability Flashcards
disability is NOT…
- > a chronic disease or traumatic injury
- > a process of sequence
disability is _____
- > an umbrella term for impairments in structure and function that affect activity and participation within the context of person al environmental factors
- > a medical and/or social construct
what is a disability MODEL
a framework for enabling the classification of limitations in activity and function and for identifying the barriers to participation
why do we need disability models
- > consistent terminology and meaning for improved communication
- > uniform/standardized measures of health indicators
- > assessing rehabilitation intervention efficacy
- > organizing and analyzing health information i.e. epidemiology, population health research
evolution of the disability model
two distinct types of models emerged during the global rise of global conflict and high rates of morbidity and with the civil rights movement
- > medial model
- > social model
medical vs social models of disability
Medical model (science, numbers ect.)
Context: person centric
Language: “person with a disability
Origin: bodily impairments
Action: identify and reduce impairments
Social Model (how society must change to accommodate)
Context: society centric
Language: a disabled person
Origin: systemic societal barriers
Action: identify and remove barriers
ICIDH
International Classification of Impairments, Disability and handicaps
- > created by the WHO in 1980
- > attempted to model disability as a continuum from disease/injury to its consequences, described as “handicaps”
Disease - > Impairment - > Disability - > Handicap
ICIDH disease vs disorder
Disease
- > a pathological condition of a part, organ, or system of an organism resulting from various causes, such as infection, genetic defect, or environmental stress, and characterized by an identifiable group of signs or symptoms
Disorder
- > and ailment that affects the function of mind or body
ICIDH impariment
any loss or abnormality of psychological, physiological or anatomical structure or function
ICIDH disability
any restriction or lack of ability (resulting from impairment) to perform an activity in the manner or within the range considered normal for a human being
ICIDH Handicap
a disadvantage for a given individual, resulting from an impariement or a disability, that limits or prevents the fulfillment of a role that is normal (depending on sex, age, and social/cultural factors)
disability model vs framework
a framework is better than a model with regards to classifying disability due to the variability of the individual and their limitation
Limitations of the ICIDH model
published research shows classification were too closely aligned w/illness
- > does not include sociological, environmental or cultural or other influences in the definition of handicap
- > consider how 2 ppl can have the same disability but impairments differ
the limitations ultimately led to the rejection of the ICIDH by the World Health Assembly
1991 Nagi model of disability
was commissioned by US Social security Administration to develop a framework for determining eligibility for disability benefits
- > very similar to ICIDH model but with a few differences
Pathology - > impairment - > functional limitation - > disability
Nagi Pathology
interruption or interference with normal processes, and effort of the organism to regain normal state
Nagi impariment
a loss or abnormality at the tissue, organ, and body system level
Nagi functional limitation
limitation in performance at the level of the whole organism or person
Nagi disability
Limitation in performance of socially defined roles and tasks within a sociocultural and physical environment
Compare and contras ICIDH vs Nagi models
See slide 23
in the ICIDH, the language infers the barrier (handicap) is due to the persons disability and Nagis Model introduces the concept that disability, at least in part, is related to the sociocultural and physical environment of the person
IOM Model (Rehab model)
Disability <- > Functional Limitation <- > Impairment
this model considers…
Risk Factors
- > predisposing factors present prior to disabling event
Intra-individual Factors
- > such as lifestyle and behavioural changes, psychosocial attributes, and coping skills, willingness to make accommodations, ect.
Extra-Individual Factors
- > pertain to the physical as well as the social context in which the disabling process occurs
Social Model of Disability and how it is applied in our society
Read slides 32-40
2001 ICF Disability Model
International Classification of Functioning, Disability and Health
- > there was still a need for a classifying system that captured all aspects of health in all cultures and societies of the world
- > organized into a framework suitable for measuring and reporting health at the individual and population levels
- > the major difference between this models and others is that “disability” is treated as an umbrella term for impairments in structure and function that affect activity and participation within the context of personal and environmental factors
SEE SLIDE 44 FOR DIAGRAM
core domains of the ICF disability model
all three core domains (body system level, person level, society level) are able to interact with on another and do not follow sequence
- > personal (intra-individual) and environmental (extra-individual) domains act to determine the relationships between the three primary domains
Capability Model
application of the ICF model
the capability model concerns turning “comodities” (goods and services) into functionings which can translate into improvements in well being
- > determines if an individuals commodities are actually helpful in their day to day life; just because a wheelchair may be available does not mean its is available, or desired by all those who might use it
