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Fundamentals · chapter 42 · Caring for Patients with Disability and Chronic Illness

Healthcare Approach to Disability

The 14 things this section of the textbook says that you are most likely to be asked about — quoted word for word, not retold. Then 6 practice questions with the reasoning.

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Key points

  1. Models guide care

    Understanding these models helps nurses ensure provision of quality health care through patient-centered and individualized care.

  2. Preventing discrimination

    A nurse’s role in preventing discrimination is crucial in providing quality health care for individuals with disabilities. Identifying and reducing these barriers is a key action for nurses.

  3. Patient autonomy

    Nurses serve as advocates for these patients and play an essential role in maintaining patients' autonomy in the presence of a disability.

  4. Models improve nursing care

    For nurses, models of disability can improve overall patient care for individuals with disabilities by framing the social, physical, and emotional challenges that these individuals face.

  5. Moral model stigma

    Overall, the moral model does not uphold inclusion, equality, or individual rights but rather blames the individual for disability and promotes stigma and negative social attitudes toward disability.

  6. Ableism in nursing care

    Although nurses cannot simply change cultural, social, or personal beliefs, they can strive to recognize ableism in their belief patterns and strive to provide inclusive and compassionate care that is free from the effects of ableism.

  7. Medical model focus

    Medical diagnoses often guide the intervention and treatment processes in the medical model rather than focus on the individual's lived experience of disability.

  8. Functional model emphasis

    The functional model of disability emphasizes the interaction between individuals and their environment, focusing on removing barriers and accommodating diverse abilities to promote equal participation and access.

  9. Rehabilitation model goal

    The goal of this model is to enable individuals to adapt to their impairments, learn new skills, and maximize their participation in various aspects of life.

  10. Social model barriers

    In the social model of disability, the individual's physical condition is considered an impairment and becomes a disability when physical and social environments create barriers to functional life.

  11. Biopsychosocial model scope

    By incorporating both concepts, the biopsychosocial model creates a more comprehensive view of disability as experienced by the individual and within society.

  12. Physical care barriers

    Physical barriers, such as doorway width, counter height, unstable flooring, noise level, and text size, are common but may be unseen by an individual without a disability.

  13. Recognizing prejudice

    Although active discrimination is unlawful, more subtle stereotyping, prejudice, and negative interaction are encountered on an individual basis. Nurses or other healthcare professionals sometimes may not even recognize their own prejudice.

  14. Nurse advocacy

    The most important role of the nurse in recognizing, preventing, and avoiding stereotypes and bias is advocating for patients.

Terms to know

moral model of disability
The moral model of disability is a long-standing belief pattern that explains disability as a defect in functioning related to the individual’s moral character.
ableism
The concept of ableism explains the adverse reactions that individuals without a disability have in response to encountering individuals with a disability.
medical model of disability
The medical model of disability explains disability as a consequence of a trauma, illness, or congenital health condition that is out of the control of the individual.
functional model of disability
The functional model of disability is closely related to the medical model and assumes a cause-and-effect relationship between a physical or cognitive deficit and limitations in daily function.
rehabilitation model of disability
The rehabilitation model of disability, sometimes referred to as the functional limitations model, conceptualizes disability as a single impairment or a collection of impairments or deficits experienced by an individual that can be improved through rehabilitation.
social model of disability
The social model of disability focuses on disability in the context of the individual’s physical and social environment rather than on an individual bodily impairment.
biopsychosocial model of disability
The biopsychosocial model of disability views impairments as the interplay between medical diagnoses and associated impairments and societal barriers.
stereotypic attitude
A stereotypic attitude is a fixed, oversimplified, and generalized perception of individuals in a specific demographic group that stems from internal and external biases.

Practice questions

Stuck on select-all-that-apply? How to take them one option at a time.

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Every question here, with the answer

  1. A client with an intellectual disability arrives for a visit with a caregiver. How should the nurse communicate during the assessment?

    1. Ask several questions at once so the visit is efficient.
    2. Speak loudly and slowly to every client with a disability.
    3. Speak directly to the client even though the caregiver is participating in care.
    4. Direct all questions to the caregiver to save time.

    Answer: Speak directly to the client even though the caregiver is participating in care.

    General communication techniques include speaking directly to the individual even if a caregiver participates, keeping a normal tone of voice. For clients with intellectual disabilities, the nurse asks one question at a time and limits directions given at once.

  2. A nurse is documenting care for a client who has diabetes. Which phrase uses person-first language?

    1. "A patient who suffers from diabetes"
    2. "A diabetic patient"
    3. "An individual with diabetes"
    4. "The diabetic in room 4"

    Answer: "An individual with diabetes"

    Person-first language such as "individual with diabetes" emphasizes the person, with diabetes only one aspect of who they are. Labeling the client by the condition or saying they "suffer from" it is ableist language.

  3. A client who uses a wheelchair cannot enter a restaurant because the only entrance has stairs. Which model of disability describes the disability as created by the lack of a ramp?

    1. Rehabilitation model
    2. Moral model
    3. Medical model
    4. Social model

    Answer: Social model

    In the social model, an impairment becomes a disability when physical and social environments create barriers, such as no alternate access like a ramp. The medical model focuses on the body's impairment, the moral model blames the individual, and the rehabilitation model focuses on restoring function.

  4. A client who is deaf arrives for a visit to discuss a new treatment plan. What should the nurse do before starting the important clinical conversation?

    1. Agree with the client on how they will communicate.
    2. Ask a family member to interpret to avoid delay.
    3. Speak louder while facing away to write in the chart.
    4. Rely on written notes only, since this is simplest for staff.

    Answer: Agree with the client on how they will communicate.

    Communication with clients with hearing impairment should be agreed upon before important clinical conversations, respecting individual preferences, and federal law requires reasonable accommodations. Choosing a method for the client, using family as interpreters, or facing away does not meet this standard.

  5. A nurse is reviewing a clinic for barriers that can affect clients with disabilities. Which findings are barriers? Select all that apply.

    1. Frequent use of medical jargon
    2. Lever-style door handles
    3. Examination tables that cannot be adjusted
    4. Education offered only in standard printed handouts
    5. Inflexible scheduling that does not allow extra appointment time

    Answer: Frequent use of medical jargon, Examination tables that cannot be adjusted, Education offered only in standard printed handouts, Inflexible scheduling that does not allow extra appointment time

    Barriers include lack of adjustable equipment, scheduling inflexibility, written-only education without accessible alternatives, and medical jargon. Lever-style door handles are an ADA accessibility feature, not a barrier.

  6. A nurse is caring for a client with a vision impairment. Which communication techniques are appropriate? Select all that apply.

    1. Face the person when speaking.
    2. Pet the client's service animal to make it comfortable.
    3. Ensure the client has glasses if they are required.
    4. Be specific when offering directions.
    5. Ask before providing physical assistance.

    Answer: Face the person when speaking., Ensure the client has glasses if they are required., Be specific when offering directions., Ask before providing physical assistance.

    For clients with vision impairment, the nurse gives specific directions, ensures assistive devices, faces the person, and respects service animal boundaries; asking before helping physically applies to all clients. Petting a service animal does not respect its boundaries.

Where every quote comes from

Section 42.2 Healthcare Approach to Disability of Fundamentals of Nursing by Christy Bowen, Lindsay Draper, Heather Moore, OpenStax, 2024. Read the whole section free at openstax.org.

The textbook is licensed under CC BY-NC-SA 4.0. This page quotes it word for word and adds the headings, the order and the practice questions; references to the book's figures and stray spaces left by its formatting are removed. The page is shared under the same licence. Nothing here is sold.