Environmental and Personal Barriers - Case Study Example

Running Head: DISABILITY Disability [Writer’s name [Institution’s name] Disability Introduction In this assessment s the environmental and personal barriers faced by Dan and Amber in the case study and the role of the health professional, the concepts of pity, paternalism, self efficacy and independence will be discussed. The barriers’ pf the both the patients, Dan and Amy have been identified and taken directly from the case study in question. Analysis of the both Cases Barriers Environmental Barriers for Amber The barriers Amber faced in functioning by the environment she moved about in was that she realized that she could no longer enter a room an “blend in” or be ignored and be treated as just another person anymore She then realized that in order for others to be comfortable around her, she had to be comfortable about herself, as self confidence puts other people at ease. She noted that people’s reactions towards her changed once they saw her in a wheelchair, they would suddenly become over accommodating and even though intentions were genuine, they didn’t realize that their assistance was demeaning the individual in the wheelchair who would prefer to perform the task themselves. They were in a sense treating them differently by assisting them. Personal Barriers for Amber Amber knew she had a lot of support from her friends and family. She drew strength from this and felt that everything would gel back on track eventually. After leaving ICU Amber went to the hospital Spinal Unit for rehabilitation. She had to re-learn simple tasks such as sitting up, dressing, and learning to transfer into her wheelchair. She then commenced work with the physiotherapist to build up her upper body strength. Amber spent a lot of time with the social worker. She had to try and get her head around her situation and all the changes that have to occur in her life as a result of what had happened to her. Environmental Barriers for Dan As for Dan he faced more barriers it was very hard for him to see his family upset by his condition, as it was also upsetting for him and reminded him of the fact that what had happened had had such an impact on all who cared for him. Dan often can’t socialize in public as the environment doesn’t accommodate for wheelchair accessibility. He faces barriers such as steps into cafes and hotels and often is provided with inaccurate information when ringing in advance to find out if the business he wishes to patron is accessible to him (such as being told there is only 1 step when in fact there are several). When he goes to stay in motels he often finds the wheelchair accessible rooms are not modified for wheelchair bound persons. Living in a rural area he finds the community and people of the community are generally more accommodating and are willing to spend money to make adjustments for his condition. He often wondered what he would do with his life once he got out of hospital. It took him 2 years to decide he wanted to work on a farm like his mum and dad had done. Personal Barriers for Dan He was worried about how he would cope at home, what would happen if his health deteriorated, how he would seek treatment, and how he would manage in general. He was also aware of how much of a big workload his care would place on his family members and was concerned about how they would manage and cope with him at home. Along with this He felt as though when he was discharged, it was very cut and dry at the time, and there wasn’t much help available for transitioning back into his community and home life. Self efficiency The health profession in both cases tried to lessen the anxiety and depression of the patient thus lessening that anxiety which yielded a affective response of high self-efficacy (Renee 2007 p27) (the feeling of being competent enough to reach one's goals) as health profession care professionals probably knew that when the when negative outcomes occur and depression is the emotional response of low self-efficacy when positive outcomes occur (Carol 2005 p12). This was especially noted in Dan’s case more than in Amber’s case as Dan’s transitional rehabilitation program also encompassed links with the spinal outreach team consisting of a specialist nurse, OT and physio who were able to provide his father with all the information he needed. The more information you were given about your condition, and how to manage it, the better off it is for you (knowledge = power and self-efficacy= independence=self esteem and self value.). In both cases the health care professionals helped Dan and Amber to master experience by means of interpreting results , they also helped them to learn by their experiences by observing others carry out tasks they showed them how to better ways for doing routine . The healthcare professional induced self efficiency in both patients as it was important for them or else the patients would not be able to be independent (Mary & Catherine 2007 p 56) Paternalism This has been defined as, ‘Behaving towards someone in a way that does not respect his or her autonomy, for that person’s (supposed) good’. ‘Paternalism characteristically involves making people’s decisions for them or keeping certain information from them on the grounds that it would be better for them not to know (cr.rsmjournals.com/cgi/reprint/13/6/226.pdf). The medical professionals in both these cases did not interfere with Dan’s and Amber’s decisions with the objective of ensuring patient benefit and preventing harm. They gave them freedom and individual control, as medical paternalism is no longer used as the dominant way of decision-making in health care. As this freedom and individual control helped them to recover and have confidence in themselves (Arthur& Robert 1995 p 23). This was more dominating in Amber’s case as due to the fact that she got all the information from the professionals dealing with her. She felt that had she been provided with all the relevant information to make decisions then she would have been more empowered and this was critical to her recovery and life after rehab in hospital. Amber concluded that she felt there needed to be standardized information given to all people relative to treatment and management of their condition. Pity Pity and empathy plays a vital role for health acre professionals in very field, however they have to also make sure that their pity does not make the patient also feel self pity (Kristofer & Allen 2006 p45). How ever in both these cases pity played an important role, but it is important to note that the professionals exhibited this pity in the form of empathy (Karen 2005 p 23) .This was relevant in both cases. In Dan’s case Health professional staffs were very understanding and empathetic towards Dan while he was in hospital and during his rehabilitation and recovery phases. They were non-judgmental and treated him with the dignity and respect that he was entitled to. He was treated as any other person and wasn’t degraded or discriminated against because of his disability. He believes that due to his positive and co-operative mindset that this attitude reflected on how the health professionals treated him. In Amber’s case, Amber was involved with the Transitional Rehab program which allowed for her to either stay in one of the TRP houses for a few months, or go home and have the TRP team come to her. The team consisted of a Social Worker, Nurse, OT and PT they were empathic towards her and felt pity for her . They provided her with rehab support during the transitioning period back into the community which allowed her to adjust and be happy. Independence Occupational therapists in both the cases organized treatments into three regarding routine activities Activities of daily living included such things as dressing, cooking, bathing and hygiene (brushing/washing hair, brushing teeth, etc.) shopping, paying bills, and so on. As the Occupational therapists knew that they had to evaluate the functioning limitations as well (Herbert etal 2005 p595). The health care professionals seemed to know that this was the need of the patient, and there may be good reason for this stance, such as being as this programme encouraged the development of independence of both Dan and Amber. The ultimate goal of Occupational therapists was to maximize Dan and Amber’s independent functioning (Fong etal 2004 p65). The term independent functioning refers to the ability to perform all daily living activities without assistive technology/devices or another person's help (Water & Michael 1981 p6). Achieving total independence is not always possible with all patients this kind of training was important for both the patients as it would also help them to regain their confidence . How ever Occupational therapists in these cases trained Dan and Amber on how to use assistive devices when necessary to perform functional tasks. Conclusion After analysing both the cases of Dan and Amy it can be concluded that the healthcare professionals did a wonderful job as now both patients live a happy and independent life. It was cooperative and confident attitude of these professionals that helped the patients live a normal life. The fact that the occupational therapist, social workers and physiotherapist exhibited no pity gave them the right to make their own decisions on their own and also helped them become independent. References Arthur E. Dell Orto & Robert P. Marinelli (1995); Encyclopedia of Disability and Rehabilitation. Macmillan Library Reference USA, p34 Carol M. Davis (2005); Patient Practitioner Interaction: An Experiential Manual for Developing the Art of Healthcare. Slack Incorporated; 4th edition p 12.\ cr.rsmjournals.com/cgi/reprint/13/6/226.pdf retrieved on 20 January 2009 Fong Chan, Norman L. Berven, Kenneth R. Thomas (2004); Counseling Theories and Techniques for Rehabilitation Health Professionals Edition: Springer Publishing Company, p65 Herbert H. Zaretsky, Edwin F. Richter III, Myron G. Eisenberg (2005); Medical Aspects of Disability: A Handbook for the Rehabilitation Professional. 3rd Edition Springer Publishing Company; 3 edition p595 Karen Whalley Hammel (2005) Perspectives on Disability and Rehabilitation: Contesting Assumptions, Challenging Practice. Churchill Livingstone Title; 1 edition p 23 Kristofer J. Hagglund, & Allen W. Heinemann (2006); Handbook of Applied Disability and Rehabilitation Research Springer Publishing Company p 45. Mary Vining Radomski & Catherine A. Trombly Latham (2007); Occupational Therapy for Physical Dysfunction: Comprehensive Atlas Edition: 6, Lippincott Williams & Wilkins, p56 Renee R. Taylor (2007) the Intentional Relationship: Occupational Therapy and Use of Self. A. Davis Company; 1 edition p 27 Water C. Stolow & Michael R. Clowers (1981); Handbook of Severe Disability: A Text for Rehabilitation Counselors, Other Vocational Practitioners, and Allied Health Professionals. United States Government Printing p6 Read More