The Disablement Model

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

1. The Disablement The Disablement
ModelModel
Presented By: Carolene Fraser, Julian Presented By: Carolene Fraser, Julian
Martin and Kadian MastersMartin and Kadian Masters

2. IntroductionIntroduction
Several definitions of disability or person Several definitions of disability or person
with disability are used in Jamaica with disability are used in Jamaica
likewise,likewise,
several models of disability have been several models of disability have been
developed over the years which seek to developed over the years which seek to
provide an analysis of the social, political, provide an analysis of the social, political,
cultural and economic factors that define cultural and economic factors that define
disability disability

3. Introduction (Cont’d)Introduction (Cont’d)
The Disablement Model is one of the many The Disablement Model is one of the many
models developed over the years.models developed over the years.
initially developed by sociologist Saad initially developed by sociologist Saad
Nagi in the 1960sNagi in the 1960s however, however,
several revisions of Nagi’s model was several revisions of Nagi’s model was
done in the mid 1990s done in the mid 1990s

4. Nagi ModelNagi Model
Nagi described four basic phenomena that Nagi described four basic phenomena that
he considered fundamental to he considered fundamental to
rehabilitation as follows:rehabilitation as follows:
active pathologyactive pathology
impairmentimpairment
functional limitations functional limitations
disabilitydisability

5. Nagi Model Cont’dNagi Model Cont’d
active pathology is an interruption in active pathology is an interruption in
normal body processes that leads to a normal body processes that leads to a
deviation from the normal state such as deviation from the normal state such as
infection, trauma, disease processes, or infection, trauma, disease processes, or
other degenerative conditionsother degenerative conditions
Impairment is a loss or abnormality at the Impairment is a loss or abnormality at the
tissue, organ, and body system leveltissue, organ, and body system level

6. Nagi Model Cont’dNagi Model Cont’d
functional limitations relates to the functional limitations relates to the
individual's inability to perform the tasks individual's inability to perform the tasks
and obligations of his usual roles and and obligations of his usual roles and
normal daily activitiesnormal daily activities
disability defined as a physical and/or disability defined as a physical and/or
mental limitation in performing socially mental limitation in performing socially
defined roles and tasks expected of an defined roles and tasks expected of an
individual individual

7. Vergbrugge and Jette ModelVergbrugge and Jette Model
Vergbrugge and Jette expanded Nagi’s
Disablement Model to include:
 sociocultural factors or factors relating to sociocultural factors or factors relating to
the physical and social environmentthe physical and social environment
personal factors which are factors personal factors which are factors
pertaining to the individual such as pertaining to the individual such as
behavioursbehaviours, , lifestyle attitudes etc. lifestyle attitudes etc.

8. Vergbrugge and Jette Model Vergbrugge and Jette Model
Cont’dCont’d
The model was an attempt to describe how:The model was an attempt to describe how:
chronic or long lasting and severe chronic or long lasting and severe
conditions affect functioning in specific conditions affect functioning in specific
body parts, mental function and daily life,body parts, mental function and daily life,

and the role of personal and and the role of personal and
environmental factors in disablementenvironmental factors in disablement

9. Vergbrugge and Jette Model Vergbrugge and Jette Model
Cont’dCont’d
Three variables developed by Verbrugge Three variables developed by Verbrugge
and Jette which are external to Nagi’s and Jette which are external to Nagi’s
model are: model are:
predisposing risks factorspredisposing risks factors
intra-individual factorsintra-individual factors
extra-individual factors extra-individual factors

10. Vergbrugge and Jette Model Vergbrugge and Jette Model
Cont’dCont’d
Predisposing risk factors are phenomena Predisposing risk factors are phenomena
that are present prior to the onset of the that are present prior to the onset of the
disabling event that can affect the disabling event that can affect the
presence or severity of the disablement presence or severity of the disablement
process; for example socio-demographic process; for example socio-demographic
background, lifestyle and biological factorsbackground, lifestyle and biological factors

11. Vergbrugge and Jette Model Vergbrugge and Jette Model
Cont’dCont’d
Intra-individual factors are those that Intra-individual factors are those that
operate within a person, such as lifestyle operate within a person, such as lifestyle
and behavioral changes, psychosocial and behavioral changes, psychosocial
attributes and coping skills, and activity attributes and coping skills, and activity
accommodations made by the individual accommodations made by the individual
following onset of a disabling conditionfollowing onset of a disabling condition

12. Vergbrugge and Jette Model Vergbrugge and Jette Model
Cont’dCont’d
Extra-individual factors are those that Extra-individual factors are those that
operate outside or external to the person operate outside or external to the person
relating to the physical as well as the relating to the physical as well as the
social context in which the disablement social context in which the disablement
process occurs. These can include medial process occurs. These can include medial
and rehabilitation services, medications and rehabilitation services, medications
and other therapeutic regimens, external and other therapeutic regimens, external
supports available in the person’s social supports available in the person’s social
network, and the physical environmentnetwork, and the physical environment

13. Institute of Medicine (IOM) ModelInstitute of Medicine (IOM) Model
IOM used the original Nagi model but IOM used the original Nagi model but
incorporated two important concepts incorporated two important concepts
known as: known as:
secondary conditions or risk factors and;secondary conditions or risk factors and;
 quality of life quality of life

14. IOM Model Cont’dIOM Model Cont’d
Risk factors included biological, Risk factors included biological,
environmental which include both social environmental which include both social
and physical, and lifestyle or behaviour and physical, and lifestyle or behaviour
factors capable of interacting with the factors capable of interacting with the
disabling processdisabling process
quality-of-life or the general wellbeing of quality-of-life or the general wellbeing of
the individual was seen to both affect and the individual was seen to both affect and
be affected by each stage of the processbe affected by each stage of the process

15. IOM Model Cont’dIOM Model Cont’d
In 1997 IOMIn 1997 IOM revised its own model as revised its own model as
follows:follows:
 disability was removed from the model, disability was removed from the model,
and was instead viewed as an outcome of and was instead viewed as an outcome of
the individual interacting within the the individual interacting within the
environment;environment;

16. IOM Model Cont’dIOM Model Cont’d
disability was defined through an disability was defined through an
"enablement-disablement process," which "enablement-disablement process," which
is important because it identifies disability is important because it identifies disability
as changeable and reversibleas changeable and reversible
the risk factors were renamed to the risk factors were renamed to
transitional factors, as they were transitional factors, as they were
responsible for the transitions between the responsible for the transitions between the
categories of the enabling-disabling categories of the enabling-disabling
process process

17. National Center for Medical National Center for Medical
Rehabilitation Research (NCMRR) Rehabilitation Research (NCMRR)
ModelModel
NCMRR incorporated the basic NCMRR incorporated the basic
phenomena described in the Nagi model phenomena described in the Nagi model
but also included a specific component but also included a specific component
related to societal influences or limitations related to societal influences or limitations
as contributors to disability as contributors to disability

18. NCMRR Model Cont’dNCMRR Model Cont’d
NCMRR defines societal limitations as the NCMRR defines societal limitations as the
restrictions resulting from social policy or restrictions resulting from social policy or
barriers, which limit fulfilment of roles or barriers, which limit fulfilment of roles or
deny access to services and opportunities deny access to services and opportunities
associated with full participation in society associated with full participation in society

19. NCMRR Model Cont’dNCMRR Model Cont’d
The model defined disability as limitations The model defined disability as limitations
in performing tasks, activities, and roles to in performing tasks, activities, and roles to
levels expected in personal and social levels expected in personal and social
contexts where focus was placed on how contexts where focus was placed on how
a person with a disability adapts to a person with a disability adapts to
functional limitations in the family, work, functional limitations in the family, work,
and local community and local community

20. NCMRR Model Cont’dNCMRR Model Cont’d
In 2006 the NCMRR started working on a In 2006 the NCMRR started working on a
new version in which rehabilitation is seen new version in which rehabilitation is seen
as an active process, requiring the active as an active process, requiring the active
participation of the patient, with the participation of the patient, with the
ultimate goal of improving the patient's ultimate goal of improving the patient's
quality of lifequality of life

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

22. THE ENDTHE END
THANK YOU THANK YOU
and and
Good NightGood Night