The Importance of Self

The Disablement Model

Presented By: Carolene Fraser, Julian Martin and Kadian Masters

Introduction

Several definitions of disability or person with disability are used in Jamaica likewise,

several models of disability have been developed over the years which seek to provide an analysis of the social, political, cultural and economic factors that define disability

Introduction (Contd)

The Disablement Model is one of the many models developed over the years.

initially developed by sociologist Saad Nagi in the 1960s however,

several revisions of Nagis model was done in the mid 1990s

Nagi Model

Nagi described four basic phenomena that he considered fundamental to rehabilitation as follows:

active pathology

impairment

functional limitations

disability

Nagi Model Contd

active pathology is an interruption in normal body processes that leads to a deviation from the normal state such as infection, trauma, disease processes, or other degenerative conditions

Impairment is a loss or abnormality at the tissue, organ, and body system level

Nagi Model Contd

functional limitations relates to the individual's inability to perform the tasks and obligations of his usual roles and normal daily activities

disability defined as a physical and/or mental limitation in performing socially defined roles and tasks expected of an individual

Vergbrugge and Jette Model

Vergbrugge and Jette expanded Nagis Disablement Model to include:

sociocultural factors or factors relating to the physical and social environment

personal factors which are factors pertaining to the individual such as behaviours, lifestyle attitudes etc.

Vergbrugge and Jette Model Contd

The model was an attempt to describe how:

chronic or long lasting and severe conditions affect functioning in specific body parts, mental function and daily life,

and the role of personal and environmental factors in disablement

Vergbrugge and Jette Model Contd

Three variables developed by Verbrugge and Jette which are external to Nagis model are:

predisposing risks factors

intra-individual factors

extra-individual factors

Vergbrugge and Jette Model Contd

Predisposing risk factors are phenomena that are present prior to the onset of the disabling event that can affect the presence or severity of the disablement process; for example socio-demographic background, lifestyle and biological factors

Vergbrugge and Jette Model Contd

Intra-individual factors are those that operate within a person, such as lifestyle and behavioral changes, psychosocial attributes and coping skills, and activity accommodations made by the individual following onset of a disabling condition

Vergbrugge and Jette Model Contd

Extra-individual factors are those that operate outside or external to the person relating to the physical as well as the social context in which the disablement process occurs. These can include medial and rehabilitation services, medications and other therapeutic regimens, external supports available in the persons social network, and the physical environment

Institute of Medicine (IOM) Model

IOM used the original Nagi model but incorporated two important concepts known as:

secondary conditions or risk factors and;

quality of life

IOM Model Contd

Risk factors included biological, environmental which include both social and physical, and lifestyle or behaviour factors capable of interacting with the disabling process

quality-of-life or the general wellbeing of the individual was seen to both affect and be affected by each stage of the process

IOM Model Contd

In 1997 IOM revised its own model as follows:

disability was removed from the model, and was instead viewed as an outcome of the individual interacting within the environment;

IOM Model Contd

disability was defined through an "enablement-disablement process," which is important because it identifies disability as changeable and reversible

the risk factors were renamed to transitional factors, as they were responsible for the transitions between the categories of the enabling-disabling process

National Center for Medical Rehabilitation Research (NCMRR) Model

NCMRR incorporated the basic phenomena described in the Nagi model but also included a specific component related to societal influences or limitations as contributors to disability

NCMRR Model Contd

NCMRR defines societal limitations as the restrictions resulting from social policy or barriers, which limit fulfilment of roles or deny access to services and opportunities associated with full participation in society

NCMRR Model Contd

The model defined disability as limitations in performing tasks, activities, and roles to levels expected in personal and social contexts where focus was placed on how a person with a disability adapts to functional limitations in the family, work, and local community

NCMRR Model Contd

In 2006 the NCMRR started working on a new version in which rehabilitation is seen as an active process, requiring the active participation of the patient, with the ultimate goal of improving the patient's quality of life

Conclusion

The disablement model has undergone several changes since its inception intended to more easily explain, measure, and interpret those factors associated with disability and also to generate or facilitate a common language amongst disablement specialists. Like any other model of disability the disablement models revision process is ongoing therefore newer versions of the model can be expected in the future.

THE END

THANK YOU and Good Night