UNIT-VII model and methods of rehabilitation.pptx

Results: Six conceptual rehabilitation models were identified in the literature: the Biomedical Model, the Social Model, the Bio-Psycho-Social Model (BPS), the International Classification of Impairments, Disabilities, and Handicaps Model (ICIDH), the Community Based Rehabilitation Model (CBR), and the Health-Related ..

1. UNIT-VII MODELS AND METHODS OF REHABILITATION DR.ANJALATCHI MUTHUKUMARAN VICE PRINCIPAL ERA COLLEGE OF NURSING

2. REHABILITATION Rehabilitation is the process of helping a person to reach the fullest physical, psychological, social, vocational, and educational potential consistent with his or her physiologic or anatomical impairment, environmental limitations, and desires and life plans. According to WHO “ Rehabilitation is the combined and coordinated use of the medical, social, educational, and vocational measures for training and re-training the individual to the highest possible level of functional ability”.

3. REHABILITATION NURSING Important and essential part of comprehensive nursing. Rehabilitation nursing ideally starts at the moment a patient enter into the health care system. However, rehabilitation program may take place in the special units of hospital or independent centre in the community.

4. OBJECTIVES OF REHABILITATION NURSING There are 4 broad objectives of rehabilitation nursing: a. To restore affected abilities to the highest possible level of function. b. To prevent further disability/ handicap. c. To protect the person abilities. d. To assist the person / patient to use his or her abilities

5. PRINCIPLES OF REHABILITATION Rehabilitation should begin during the initial contact with the patient. Restoring the patient to independent or to regain his pre- illness/pre-disability level of function in as short a time as possible. Maximizing independence within the limits of the disability. He must be an active participant. The activities of daily living are facilitated. The individual with a disability is encouraged to wear his clothing enhances self-esteem and dignity. Motivates the patient and helps him to attain social independence. Focus is on the needs of groups of people with specific condition Every patient has a right to the rehabilitation services.

6. METHODS OF REHABILITATION NEUROLOGICAL REHABILITATION In this type of rehabilitation, patients suffering from stroke, neuromuscular disease, certain types of head trauma and spinal cord injury are treated. It aims at making the patient self-dependent It helps create a positive thinking in patient The patient is treated so that he leads a improved life physically, emotionally, and socially.

7. CARDIAC REHABILITATION Cardiac rehab program is designed to help those people who have heart problem. Heart patients are educated to live a healthy life and reduce stress for the proper functioning of the heart. Educating people about the various risk factors that contribute to developing a heart disease. These risk factors include, high blood pressure, obesity, smoking, drinking, drug abuse, lack of physical activity, etc. Recovery programs from heart disease/surgery. Educating people about improving their quality of life.

8. DRUG REHABILITATION Drug rehabilitation programs involve programs that are designed to make an addict free from the addiction of alcohol,prescription drug and street drugs (cocaine, heroin etc)

9. ALCOHOL REHABILITATION Alcohol rehabilitation program is designed to make an alcoholic free from the addiction. It involves programs that will teach people the various bad effects of consuming excess alcohol Effective detox programs that will cleanse the body from the various toxins of alcohol

10. PHYSICAL REHABILITATION Physical rehabilitation is for those people whose lifestyle has changed after they have gone through a serious illness, surgery, accident or illness. Here the therapist introduces programs to improve the mobility and functioning of the injured body part of the patient. Proper exercising program is designed to improve the functioning often physical body. Includes therapies that will help a patient re-learn the basic physical and cognitive functioning.

11. VOCATIONAL REHABILITATION Programs focus on improving major and minor skills that are in the basic life. Assessing patient in every step to improve the activities of basic Vocational rehab program is designed to help those people who find it difficult to employment or retain it they have gone through certain situation that caused mental or physical disability in them. Providing physiological and medical assessment Job placement, job training and on job training

12. MEDICAL REHABILITATION Medical rehabilitation includes treatment programs that help a person perform better in all his daily physical and mental activities. Medical rehabilitation is a follow up treatment after any kind of treatment program.

13. VESTIBULAR REHABILITATION It helps in improving the ear deficit by working the central nervous system. Also deals in improving eye and head coordination STROKE REHABILITATION This treatment type helps to restore damage that is caused after a stroke, which is the 3 rd leading cause for death worldwide Stroke rehabilitation aims at helping people gain normal functioning after the occurrence of a stroke. Help the person to get back to normal lifestyle and be independent in daily activities.

14. COMMUNITY BASED REHABILITATION

15. Evaluation for community based rehabilitation

16. MODELS OF REHABILITATION NAGI MODEL The Disablement Model is one of the many models developed over the years initially developed by sociologist Saad Nagi in the 1960,several revisions of Nagi’s model was done in the mid 1990 Nagi described four basic phenomena that he considered fundamental to rehabilitation as follows. active pathology impairment functional limitations  disability

17. Continued 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. Functional limitations relate to the individual's inability to perform the tasks. Disability defined as a physical and/or mental limitation in performing socially defined roles and tasks expected of an individual. For instance, a 12-year old girl with mental retardation does not attend school, she stays home with her parents helping with household chores

18. INSTITUTE OF MEDICINE (IOM) MODEL IOM used the original Nagi model but incorporated two important concepts in known as secondary conditions or risk factors and quality of life 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.

19. Stroke rehabilitation

20. 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. disability was defined through an "enablement-disablement process," which is important because it identifies disability is 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.

21. NATIONAL CENTER FOR MEDICAL REHABILITATION (NCMRR ) NCMR Rincorporated the basic NCMRR incorporated the basic 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 as contributors to disability. NCMRR defines societal limitations as the restrictions resulting from social or barriers, which limit fulfilment of roles or deny access to services and opportunities associated with full participation in society. 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, local community. 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.

22. A NEW MODEL FOR THE ENABLING-DISABLING PROCESS A common understanding of such terms as injury, impairment, handicap, functional limitation, disabling conditions, and disability is essential to building effective, coherent programs in rehabilitation science and As described above, several frameworks have been to describe disability-related concepts, but none of these been universally adopted. The lack of a uniformly accepted conceptual foundation is an obstacle to research and to other elements critical to rehabilitation science and engineering. this committee presents a new set of models, based primarily on the previous IOM model (1991), to enhance the robustness of the previous models with respect to reversing the disabling process, i.e., This section presents an overview of "the enabling-disabling process," explains its stages, and describes the nature of disability

23. NEW IOM MODEL Some modifications are designed to both improve the model and to adapt it more towards rehabilitation. The 1991 IOM model (IOM, 1991) established a new conceptual foundation the field of disability in that it analyzed and described the components of the disabling process in such a way as to for the identification of potential points for preventive intervention. Identifying and describing the importance of the different types of risk factors that affect the disabling process as well as the interaction and integral nature of quality of life were fundamental contributions to the emerging field of disability prevention. Over time, however, some shortcomings in the 1991 IOM model have emerged, including the implication that the disabling process is unidirectional, progressing inexorably toward disability without the possibility of reversal.

24. The person: Arrows pointing left were added to represent the potential effects of rehabilitation and the "enabling process" (risk factors and enabling factors are now combined into "transitional factors"). In addition, the new model includes the designation "no disabling conditions" to indicate that there is a beginning and an end to the disabling process when a pathology, impairment, functional limitation, disability does not exist. The environment: The shaded gray area from the 1991 model becomes "the environment," including the physical, social, and psychological components of the environment, and is represented as a three- dimensional mat that supports and interacts with the person and the disabling process, serving to highlight the importance of the person- environment interaction. Disability: The box that was labeled "disability" in the 1991 model has been moved from being a part of the disabling process to being a product of the interaction of the person with the environment.  The Person In the new model a new designation was added to indicate people with no disabling conditions. This feature of the model will allow for ''complete" rehabilitation

25. Transitional Factors Transitional Factors in the new model, the committee defines the converse of risk factor as "enabling factor .“ Risk factors are phenomena that are associated with an increase in the likelihood that an individual will move from left to right in the new model, that is, from no disabling condition toward functional limitation. In contrast, enabling factors are phenomena that are associated with an increase in the likelihood that an individual will move from right to left in the new model, that is, toward less limitation. He general types of enabling factors are the same as the general types of risk factors, that is, environmental (social, psychological, and physical) along with lifestyle and behavioral. Thus , since both disabling and enabling factors affect transitions between the stages of the model, the committee groups them together as "transitional factors."

26.  The Environment The environment is represented as a flexible three-dimensional mat in the new model. The strength and resilience of this mat are proportional to the quantity and quality of accessible support systems and the existence of various Stronger mats equate with more supportive environments, for example, access to appropriate health care, the availability of assistive technology social support networks, and receptive cultures. Weaker mats equate with non-supportive environments. For example, physical barriers, discrimination, lack of accessible and affordable assistive technology, and lack of appropriate health care result in greater displacement of the mat and, therefore, cause greater disability.

27. Continued The environment is represented as having two general categories: the social-psychological and the physical. Psychological and Social Environments Discrimination, Access to health and medical care, Appropriate care, Access to technology Culture , Employment, Family, Economy, Community organizations, Access to social services, Traits and personality factors, Attitudes and emotional states, Access to fitness and health-promoting activities, Education, Spirituality, Independence Physical Environments Architecture, Transportation, Climate, Appropriate technology, Geography, Time

28. Enabling disability process

29. MODEL OF REHABILITATION

30. BIOMEDICAL REHABILITATION MODEL

31. CONTINUED

32. EDUCATIONAL REHABILITATION MODEL

33. SOCIAL REHABILITATION MODEL

34. ECONOMIC REHABILITATION MODEL

35. COMMUNITY BASED REHABILITATION MODEL

36. Community based rehabilitation (CBR) Introduction

37. DEFINITION CBR

38. COMPREHENSIVE REHABILITATION MODEL

39. TYPES OF REHABILITATION

40. PHYSICAL REHABILITATION

41. Occupational rehabilitation

42. Speech /swallow rehabilitation therapy

43. Cognitive rehabilitation therapy

44. Vocational rehabilitation therapy

45. Summary Today we have discussed about model and methods of rehabilitatio n like introduction, definition, rehabilitation nursing, objectives, models, methods and application of community .

46. conclusions I hope you all understand about the models and methods of rehabilitation . If got chance to apply this model and methods in community area will you able to apply though this knowledge confidently.

47. References Clark M, J. ‗Nursing in the Community‘, Appleton and Lange, Connecticut, Latest Edn Clemen – Stone S, Eigsti D, G. McGuire S, L. Comprehensive Family and Community Health Nursing, Mosby, Latest Edn . Cookfair J, M. Nursing Process and Practice in the Community, Mosby, Latest Edn . Dharr G, M.Robbani I, Foundations of Community Medicine Elsevier, Latest Edn . Gulani K, K. Community Health Nursing:Principles and practices. Latest Edn . Kerr J, Community Health Promotion Tindall , Latest Edn . Loudan , N. Glasier A, Gebbie A Hand book of Family Planning Reproductive Health Care, Churchill Livingstone. Latest Edn .