The Second Fifty Years Promoting Health and Preventing Disability (1992) / Chapter Skim
Currently Skimming:
Disability Classification
Disability Classification
Pages 22-32
The Chapter Skim interface presents what we've algorithmically identified as the most significant single chunk of text within every page in the chapter.
Select key terms on the right to highlight them within pages of the chapter.
From page 22... ...
Issues of disability classification have often revolved around the politically sensitive task of deciding whether particular individuals are eligible for social insurance programs, a process that in many circumstances provokes significant controversy. Many health professionals have, therefore, attempted to avoid these controversies by avoiding disability.7 With the prospect of providing care for an ever-larger aging population, however, the problems of disability classification deserve fresh attention.
|
From page 23... ...
if An acute care framework provides a poor view of disability for a number of reasons. Acute care perspectives are primarily restricted to somatic conditions, yet contemporary concepts of disability include phenomena that go well beyond this sphere.
|
From page 24... ...
Unlike human organs, an individual's life in society cannot be neatly divided into separate parts or components; when such divisions are attempted, the enormous variety of human existence guarantees small likelihood of consensus regarding either the divisions themselves or what constitutes "normal functioning" within them. These incompatibilities are evident in the structure of acute care thinking.
|
From page 25... ...
It therefore requires a common set of definitions, shared concepts to guide health policies and permit the dialogue necessary to advance disability treatment and prevention among health care providers. The following section discusses two of the recent efforts to classify disabilities and presents the committee's recommendations for the future development of this field.
|
From page 26... ...
Although not dependent on the disease model, they do not have a systematic means of defining psychological difficulties, and they do not provide insight into certain social contributions to disability, such as discrimination. The systems measuring limitations in major activities, on the other hand, may indicate the presence of some social contributions to disability but do not provide sufficient information to inform health interventions.
|
From page 27... ...
They both address somatic, cognitive, economic, and psychosocial dynamics; however, although they share common names for some of their categories, the criteria for determining category boundaries differ. The Nagi system is intended to provide general categories and a common conceptual mode!
|
From page 28... ...
xpenence Exterionzed Objectified Socialized ~ General Progression of the Consequences of Disease ~ Example: Osteoporosis Hip Climbing Mobility and with hip impairment staircases, independence fracture steps, walking handicaps FIGURE 2-1 The World Health Organization's International Classification of Impairments, Disabilities, and Handicaps. the landscape of health services by introducing measures of disability designed to direct system users to new health care goals.
|
From page 29... ...
Because the WHO system was designed as a classification manual for the consequences of disease, it does not elaborate the particular conditions that fall under the disease/disorder level. Impairments, the first WHO level with detailed subcategories, include "any loss or abnormality of psychological, physiological, or anatomical structure or function." As noted in the description above, these changes occur, in principle, at an organ level and begin with the development of pathological processes [although the impairment may outlast the pathological activity or may be of genetic origin)
|
From page 30... ...
The system provides detailed subcategories specifying functional limitations of particular limbs and major skeletal components such as hip and thigh impairments. Resulting difficulties in walking on flat terrain, traversing discontinuities (e.g., occasional steps between levels or the gap between platform and trainI, or climbing staircases are separate subcategories under the disabilities classification level.
|
From page 31... ...
Thus, methods that appear relevant and useful today may become outmoded as the discussion of disability classification continues. It is the committee's hope that widespread use of the WHO system will bring health professionals into this arena to contribute their views and insights to the development of alternative approaches.
|
From page 32... ...
Chronic illness, disability, and increasing longevity.
|
Key Terms
This material may be derived from roughly machine-read images, and so is provided only to facilitate research.
More
information on Chapter Skim is available.