Health Education and Learning Model In Nursing Education

How Describe Models In Nursing Education

Related Models and Definitions In Nursing Education

What are Models and Definitions In Nursing Education

    Kaplan (2010) describes four models or perceptions of disabilities that influence the way in which disabilities are addressed in society:

    The moral model the medical model ties as sin, is an old model that unfortunately persists in some cultures. When a disability is viewed as sinful, individuals and their families not only experience guilt and shame but may also be denied the care they require. 

    The United Nations has established a set of Standard Rules on the Equalization of Opportunities for Persons with Disabilities specifying that individuals with disabilities have a fundamental right of access to care, rehabilitation, and support services (United Nations, 1993; WHO, 2015b). WHO assists countries to comply with this United Nations ruling.

    The medical and rehabilitation models are similar in that both view disabilities as problems requiring intervention, with the goal being cure, “normalcy,” or reduction of the perceived deficiency (Kaplan, 2010; Shyman, 2016 ) . The health or rehabilitation professional is central to both models. 

    Many positive results have come out of efforts to develop medical and surgical treatment, prostheses and other equipment, and strategies to improve the quality of life of people with disabilities.However, the underlying belief associated with these two models-namely, that people with disabilities must be “cured” or “fixed” has been criticized by disability advocates. 

    The difference between the two models is that the medical model views disability as a defect or sickness, whereas the rehabilitation model sees disability as a deficiency. The medical model particularly is blamed for promoting expensive procedures in attempts to treat conditions that often cannot be cured. 

    The rehabilitation model, on the other hand, is less invasive and can fix or alleviate a disability through less expensive approaches such as physical therapy, counseling, and training services (Kaplan, 2010).

    The disabilities model, sometimes referred to as the social model, is the framework that has had the most influence on current thinking. The disabilities model embraces disability as a normal part of life and views social discrimination, (Kaplan, 2010). 

    According to this model, people with disabilities are often excluded from social, political, relational, cultural, and economic aspects of mainstream life and it is this exclusion that is most problematic. 

    Whereas the medical and rehabilitation models focus on the problem or condition of the individual disability, the disabilities or social model views as a social construct and focuses on barriers in society that limit opportunities (Matthews, 2009).

    Definition of the Term Disability The term has been defined in different ways disability, with many of these definitions reflecting one or more of the models described by Kaplan (2010). Most definitions are broad and serve to categorize a wide variety of impairments stemming from injury, genetics, congenital anomalies, or disease. 

    Some definitions go beyond the underlying physical or mental health issue to include different responses by societies to the individual who has a disability. For example, WHO (2016a) defines disability as “a complex phenomenon, reflecting an interaction between features of a person's body and features of the society in which he or she lives” (para. 2). 

    The connection that this definition makes between an individual's ability and the expectations of society reflects the spirit of the disabilities model and gives recognition to the environmental and social barriers faced by people with disabilities. WHO uses the International Classification of Functioning, Disability and Health, known more commonly as ICF, as a framework for measuring health and disability at the individual and population levels. 

    Adopted in 2001, the ICF provides a means of classifying the consequences of disease and trauma and recognizes three dimensions of disabilities: body function/impairment, activity/restrictions, and participation/restrictions (Centers for Disease Control and Prevention [CDC], 2012b ) . The ICF identifies disability as a universal human experience and places emphasis on the impact of a disability rather than on its cause. 

    In the United States, the Social Security Administration (SSA, 2016) defines disability in terms of an individual's ability to work. This definition and its associated criteria are designed to be used to determine eligibility for Social Security payments for individuals with severe disabilities. 

    The criteria used by the SSA require that individuals be classified as disabled only if they have a long-term or fatal condition that makes it impossible for them to continue in their current role or adapt to other work for an extended period of time. The SSA does not pay benefits for partial or short term disability.

    On July 26, 1990, President George HW Bush signed into law the Americans with Disabilities Act (ADA). The definition of disability under the ADA is “a physical or mental impairment which substantially limits one or more of the major life activities of the individual” (US Department of Justice, 2009, p. 1). 

    A major life activity includes functions such as caring for one- self, standing, lifting, reaching, seeing, hearing. speaking, breathing, learning, and walking. This significant legislation has extended civil rights protection to millions of Americans with disabilities.

    The first part of the law, which became effective in January 1992, mandated accessibility to public accommodations. The second part of the law went into effect in July 1992 and required employers to make reasonable accommodations in hiring people with disabilities (Merrow & Corbett, 1994; Pelka, 2012).

    Although the ADA's definition of disability, with its emphasis on physical and mental impairments, may give the impression that it is steeped in the medical or rehabilitation model. the protections it provides are consistent with the disabilities model. The ADA legislation. makes it illegal to discriminate based on a disability in the areas of employment, public service, public accommodations, transportation, and telecommunications. 

    On a practical level, it means that an individual cannot be denied employment or promotion because of misconceptions or biases regarding that individual's disability (Pelka, 2012). ADA legislation provides the foundation on which all facets of society will be free of discrimination, including the healthcare system. 

    Therefore, health professionals can expect to encounter people with disabilities in every setting in which they practice, such as schools, clinics, hospitals, nursing homes, workplaces, and private homes. Persons with a disability will expect nurses and other healthcare professionals to provide appropriate instruction adapted to their special needs.