Workshop on Disability in America A New Look: Summary and Background Papers (2006) / Chapter Skim
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Appendix J Secondary Conditions and Disability--Margaret A. Turk
Appendix J Secondary Conditions and Disability--Margaret A. Turk
Pages 185-193
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From page 185... ...
Although the term itself was new, the concept that people with disabilities experienced ongoing health problems that were somehow associated with their primary disabling conditions was not new either to them or to the clinicians who treated them. This paper reviews the evolution of the concept of a secondary condition, describes its components, discusses areas of disagreement regarding the definition, and places secondary conditions within the taxonomies of disabilities used in rehabilitation science and clinical practice.
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From page 186... ...
This national organization promotes interactions and information sharing among consumers, professionals, and agencies regarding secondary conditions and wellness for individuals with disabilities. KEY DIMENSIONS OF SECONDARY CONDITIONS No single seminal article has defined and enumerated secondary conditions.
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From page 187... ...
Examples of common secondary conditions (some of which may also develop in their own right as primary conditions) include • pain, • osteoporosis, • renal insufficiency, • chronic lower limb edema, • pressure ulcers, • obesity, • depression, and • insulin-resistant diabetes mellitus (in individuals with spinal cord injuries)
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From page 188... ...
condition is actually linked to a disability, for example, diabetes and spinal cord injury, as described by William Bauman in his paper in Appendix M of this workshop report. Such advances in medical knowledge must be disseminated to providers and consumers if it is to be effectively applied to prevent or manage secondary conditions.
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From page 189... ...
The traditional clinical taxonomies used to describe disability employ terms such as primary disabling condition or primary condition, associated conditions, comorbidities, aging, and health. This terminology is used within the narrow context of disability; however, the context can certainly be broadened to include chronic medical conditions as such, for example, diabetes and hypertension.
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From page 190... ...
In Figure J-1, the small rectangle represents the usual curve of skill attainment to a typical peak performance quotient, followed by a gradual loss of performance over time, if it is assumed that no exercise or focused performance training activity is carried out. The triangle represents a physically trained individual, who will show a higher maximum performance quotient related to exercise and activity and who will maintain a higher level of performance over time, if it is assumed that continued activity and exercise are performed.
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From page 191... ...
Finally, the diamond represents the pattern for someone with a developmental disability who is unable to achieve the typical performance quotient and who shows a faster decline in function. Note the lower performance capacity of the disability-related function and, therefore, the likely more limited reserve capacity for changes in health or the addition of medical conditions.
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From page 192... ...
Both are likewise consistent with an understanding that environmental factors and personal choices or traits can affect the development of secondary conditions and the extent to which primary or secondary conditions become disabling. The 1997 version of the IOM model emphasizes quality of life for people with limitations or disabilities as another variable that may be affected by environmental factors and personal characteristics.
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From page 193... ...
Department of Health and Human Services. World Health Organization (WHO)
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