MODEL KETIDAKMAMPUAN Disability model

  MODEL

KETIDAKMAMPUAN

Disability model

  

The Nature of Physical Therapy

Physical Therapy is providing services to people and populations to develop, maintain and restore maximum movement and functional ability throughout the lifespan.

  Physical therapy includes the provision of services in circumstances where movement and function are threatened by the process of ageing or that of injury or disease.

  Full and functional movement are at the heart of what it means to be healthy.

   Pelayanan Fisioterapi ditujukan kepada perorangan dan masyarakat

Lingkup pelayanan Fisioterapi adalah Mengembangkan, memelihara,

   dan memulihkan

Yang menjadi bidang garapan Fisioterapi adalah (maksimilisasi) Gerak

 dan (kemampuan) Fungsi 

  Apakah yang dikerjakan Fisioterapi

Physical therapy is concerned with identifying and maximizing

movement potential, within the spheres of promotion,

prevention, treatment and rehabilitation. Physical therapy

involves the interaction between physical therapist, patients

or clients, families and care givers, in a process of assessing

movement potential and in establishing agreed upon goals and

objectives using knowledge and skills unique to physical

therapists.

  Fisioterapi mengenali dan memaksimalkan potensi gerak yang berhubungan dengan lingkup promosi, prevensi, penyembuhan dan pemulihan. Fisioterapi ikut dalam interaksi antara Fisioterapis, pasien atau klien, famili dan pemberi pelayanan kesehatan dalam proses pemeriksaan potensi gerak dalam upaya penegakan

  …...Fisioterapi

The physical therapists' distinctive view of the

body and its movement needs and potential is

central to determining a diagnosis and an

intervention strategy and is consistent whatever

the setting in which practice is undertaken. These

settings will vary in relation to whether physical

therapy is concerned with health promotion:

prevention, treatment or rehabilitation.

  

Fisioterapis secara khusus memandang tubuh dan kebutuhan

potensi gerak merupakan pusat penentuan diagnosis dan

strategi intervensi dan konsiten dengan bentuk apapun

dimana praktek fisioterapi dilakukan.

Bentuk pelayanan Fisioterapi akan sangat bervariasi dalam

hubungannya dengan dimana Fisioterapi bekerja maupun

  KEPMENKES 1363

Fisioterapi adalah bentuk pelayanan

kesehatan yang ditujukan kepada

individu dan atau kelompok untuk

mengembangkan, memelihara dan

memulihkan gerak dan fungsi tubuh

sepanjang daur kehidupan dengan

menggunakan penanganan secara

manual, peningkatan gerak, peralatan

(fisik, elektroterapeutis dan mekanis),

DEFINISI FISIOTERAPI

• • Pelayanan kepada individu dan

  masyarakat

• • Mengembangkan, memelihara,

  

memulihkan gerak dan fungsi

• Sepanjang daur kehidupan
• Dengan modalitas fisioterapi

  Nagi Model berdasarkan pada konsep

• penyakit atau aktif patologi,
• impairtment,
• keterbatasan fungsi,
• dan disability

  Nagi model penyakit / aktif patologi, impairtment keterbatasan fungsi, (Functional limitation ) Ketidak mampuan ( Disability )

  Nagi model

• aktif patologi adalah interruption/ berhentinya atau interference

  proses normal dan usaha organisme secara simultan untuk

  memperbaikinya sendiri ke keadaan normal dengan mobilisasi

  defense tubuh dan mekanisme coping,
• impairtment adalah hilangnya atau abnormalitas anatomi, fisiologikal, mental atau psikologikal atau fungsi;
• keterbatasan fungsi atau restriksi kemampuan untuk melakukan tindakan fisik, tugas atau efisiensi aktifitas, harapan khusus, atau kompeten pada tingkat semua organisme dan person;
• disability adalah ketidakmampuan untuk melakukan atau

  keterbatasan dalam melakukan tindakan, tugas, aktifitas yang

  biasanya diharapkan dalam peran social khusus untuk individu atau diharapkan untk status person atau peran dalam konteks

  WHO

• Pada tahun 1980, World Health Organization (WHO) dikembangkan suatu model disablement alternative.

• Dalam WHO International Clasification of

  Impairtment, Disabilities and Handicaps (ICIDH),

  World Health Organization Disability model penyakit /

  Ketidak impairtment HANDICAPED disease mampuan

WHO MODEL

• desease/penyakit didefenisikan sebagai perubahan patologi yang ditunjukkan

  sebagai suatu kondisi kesehatan yang berubah atau attribute status kesehatan individu yang akan membawa pada suatu distress, interference dengan aktifitas sehari-hari atau kontak dengan pelayanan kesehatan.

• Impairtment didefenisikan sebagai perubahan abnormal pada tingkat molecular,

  

selular dan jaringan melalui struktur dan fungsi abnormal pada tingkat organ;

• disability restriction atau kurangnya kemampuan untuk melakukan aktifitas

  umum dengan cara yang normal;

• handicap didefenisikan sebagai ketidakmampuan untuk berfungsi pada tingkat

  person to person atau pada tingkat person to lingkungan. Handicap menunjukkan disadvantage sosial yang berhubungan dengan impairtment atau disability yang membatasi atau mencegah pemenuhan peran normal. WHO merevisi formulasi original model disablement dan pada desembar 2000 mengeluarkan versi pre – final yang berjudul ICIDH 2 : International Classification of Functioning Disability and Health. NCMRR (1992 ) National Center For Medical • Rehabilitation and Research (NCMRR) mempublikasikan suatu model disablement yang diambil dari Model Nagi dan WHO yang digunakan pada

  NCMRR (1992 )

• patofisiologi,
>impairtment,

• • keterbatasan fungsi,

• disability dan

  • keterbatasan social.

  NCMRR Model NCMRR menolak konotasi • negative dari bentuk “handicap” dan diusulkan untuk menggantinya dengan bentuk “keterbatasan societal” untuk menghitung

keterbatasan – imposed by society -

membatasi kemampuan orang untuk berpartisipasi secara independent

  (IOM) Pada tahun 1991, Institute Of • Medicine (IOM) menempatkan keempat model disablement untuk menekankan prevention, diusulkan

bahwa disability mungkin dicegah

melalui control resiko fisik dan resiko factor lingkungan social dalam factor resiko gaya hidup dan

  Health condition Environmental Body functions/

  Body structures

Activities

Participation

  

The ICF: Conceptual

Model

1. The ICF integrative bio-psycho-social model of functioning and

  Health condition Environmental Personal Body functions/ Body structures Activities Participation

  

disability

Case Example

1. The ICF integrative bio-psycho-social model of functioning and

  

Case Example

disability

  

A health condition is an umbrella term for disease, disorder, injury or

trauma.

  A health condition may also include other circumstances, such as ageing, stress, pregnancy, congenital anomaly, or genetic predisposition Health conditions may be coded using the ICD-10.

  Health condition Body functions/ Activities Participation Body structures

1. The ICF integrative bio-psycho-social model of functioning and

  

Case Example

disability

  

Body functions are physiological functions of body systems, including

psychological functions Body structures are anatomical parts of the body, such as organs, limbs and their components Impairments are problems in body functions or structure such as a significant deviation or loss

  Tetraplegia Health condition

  G83.5

  Body functions/ Activities Participation Body structures

1. The ICF integrative bio-psycho-social model of functioning and

  Case Example disability

  Physical Therapist: Beside Mr. Wun‘s complete problems in the lower extremity, he has partial

  Tetraplegia deficits of muscle power in the arms.

  muscle power in the arms Health condition

  G83.5

  Due to his loss of movement in his legs, movement in his legs he demonstrates stiffness in the stiffness in the muscles muscles and reduced mobility in the mobility in the ankle joints ankle joints. As a consequence of the

  Body

  Activities Participation

  loss of muscle power he has also functions/ problems with his respiratory functions respiratory functions

  Body structures

  Environmental Personal factors factors

1. The ICF integrative bio-psycho-social model of functioning and

  

Case Example

disability

  Activity is the execution of a task or action by an individual Participation is involvement in a life situation.

  Activity limitations are difficulties an individual may have in executing activities

Participation restrictions are problems an individual may experience

in involvement in life situation

  Tetraplegia

  Health condition

  G83.5

  

muscle power in the arms

movements in his legs stiffness in the muscles

  Activities Participatio

mobility in the ankle joints

respiratory functions n

1. The ICF integrative bio-psycho-social model of functioning and

  Case Example disability

  Tetraplegia

  „ My problems in daily living are Health condition

  G83.5

  that I need much more time for eating, and I can‘t go to the toilet. eating go to the toilet

  To maintain sitting is difficult, I maintain sitting muscle power in the arms

movements in his legs

always need my arms to prop up. I stiffness in the muscles

  Activities Participatio can‘t go out to meet my friends, meet my friends mobility in the ankle joints

respiratory functions

n but I still communicate to them by phone or E-Mail.

  I also started to work on the computer, doing work on the computer

  Environmental Personal

  translations from English to Thai

  factors factors

  ….“

1. The ICF integrative bio-psycho-social model of functioning and

  Case Example disability

  Environmental factors make up the physical, social and attitudinal environment in which people live and conduct their lives.

  These factors are external to individuals and can have a positive or negative influence on the individual’s performance as a member of society, on the individual’s capacity to execute actions or tasks, or on individual’s body function or structure

  Tetraplegia Health condition G83.5

  muscle power in the arms movements in his legs eating meet my friends stiffness in the muscles go to the toilet

  Activities Participation

  work on the computer mobility in the ancle joints maintain sitting respiratory functions

1. The ICF integrative bio-psycho-social model of functioning and

  Case Example disability

  „My wheelchair is very heavy, that wheelchair is very heavy

  Tetraplegia makes it difficult for me to move it.

  Health condition

  G83.5

  Most of the buildings outside are buildings not adapted for disabled. The streets are full of obstacles; streets are full of muscle power in the arms eating impossible to overcome.

movements in his legs

obstacles go to the toilet meet my friends

stiffness in the muscles

  The support of my mother is most Activities Participatio support of my mother maintain sitting work on the computer mobility in the ancle joints important for me, additionally we respiratory functions n have two housekeepers who help housekeepers me all the time.

  My health insurance pays for all my health insurance

  Personal hospital stays, that helps also.

  Environmental

  factors

  factors

1. The ICF integrative bio-psycho-social model of functioning and

  Health condition Activities Participatio n

  Personal factors are the particular background of an individual’s life and living, and comprises features of the individual that are not part of a health condition or health state.

  These factors may include gender, race, age, other health conditions, fitness, lifestyle, habits, coping styles, social background, education, profession, past and current experience,…

  Tetraplegia G83.5

  movements in his legs stiffness in the muscles muscle power in the arms mobility in the ancle joints respiratory functions eating maintain sitting go to the toilet meet my friends work on the computer

  disability Case Example

1. The ICF integrative bio-psycho-social model of functioning and

  Case Example disability

  Medical Doctor: Tetraplegia

  „Mr Wun is 24 years old, he 24 years old

  Health condition G83.5 finalized his university degree university degree for engeneering last year. engeneering

  Although his disease is severe muscle power in the arms he is motivated to improve his

movements in his legs

motivated eating meet my friends stiffness in the muscles go to the toilet situation.

  Activities Participatio work on the computer mobility in the ancle joints maintain sitting n

respiratory functions

wheelchair

  Environmental Personal buildings streets are full of obstacles factors factors support of my mother housekeepers health insurance