Chapter 7: Disability and Chronic Illness in Nursing

Disability and Chronic Illness in Nursing explores various theoretical frameworks for understanding disability, contrasting the Medical Model, which views disability as a problem requiring cure, with the Social Model, which identifies societal barriers as the primary disabling factor, and the Interface Model, which empowers patients by defining the problem at the intersection of the diagnosis and environmental barriers. The text examines the demographics and prevalence of disability, highlighting that a significant portion of the global population lives with impairments, often exacerbated by poverty and limited access to healthcare. Key categories of disability are detailed, including developmental, acquired, sensory, and psychiatric disabilities, alongside the concept of multiple chronic conditions (MCC) which significantly increases the complexity of care. The chapter emphasizes the critical role of federal legislation, such as the Americans with Disabilities Act (ADA) and the Rehabilitation Act of 1973, in mandating reasonable accommodations and physical accessibility in healthcare settings. A major focus is placed on nursing management, stressing the importance of using people-first language to respect human dignity and employing specific communication strategies for patients with vision, hearing, or cognitive deficits. Furthermore, the content outlines the trajectory of chronic illness, the necessity of health promotion to prevent secondary health conditions like pressure injuries or depression, and the vital role of transitional care in supporting patients and caregivers within home and community-based settings. Finally, it addresses the modifiable risk factors contributing to the rise of chronic diseases, such as tobacco use and obesity, and the importance of addressing social determinants of health to reduce disparities.