Summary

The terms disability and impairment are often used interchangeably. However, most definitions explain impairments as physical or mental deficits or differences that can be seen or perceived. Disability relates to how impairments affect an individual’s ability to function in their home and community environment. Physical, cognitive, and congenital impairments often result in disabilities. Disabilities are the consequence of impairments that limit the ability of individuals to perform physical actions, cognitive processes, learning tasks, or communication in expected ways. Physical disabilities may arise at birth, develop over time, or occur as a result to an acute injury. Cognitive, intellectual, developmental, and psychiatric impairments result in a wide variety of disabilities. Disabilities are common at all ages, but the type of disability varies during the life span. Although congenital and developmental disabilities are often diagnosed in childhood, the effects of these disabilities on functioning persist throughout an individual’s life. Older adults commonly develop disability related to mobility and sensory changes associated with disease and the aging process. These disabilities affect an individual's daily functioning at home, school, and in the wider community. Disabilities can be congenital, progressive, or acquired, and a person’s response to disability depends on factors such as the severity of the disability, available support, and grief response.

Models of disability are essential for framing patient-centered care planning and creating an awareness of how healthcare professionals and the broader community view disability. These models relate to the morals, medical care, social interactions, functional abilities, rehabilitation, social, and biopsychosocial aspects of caring for individuals with disabilities. Although each model can be understood independently, understanding the interplay between these concepts is key to providing individualized care. Individuals with disabilities experience a wide range of barriers, from physical difficulty accessing a building to the inability to communicate effectively with their healthcare provider. By recognizing barriers, nurses can eliminate physical obstacles and social bias in their care setting. Helping individuals access affordable care, navigate insurance requirements, and feel accepted and included are all ways that nurses can ensure quality health care for people with disabilities.

Chronic conditions are prevalent in our society. The most prevalent chronic diseases in the United States are CVD (50 percent), obesity (42 percent), and arthritis (25 percent). Other prevalent chronic diseases include diabetes, cancer, epilepsy, and pain. Chronic diseases encompass many disorders that can be identified by specific medical criteria. Chronic illness, on the other hand, describes the patient’s experience with a chronic condition, including symptoms, time frame, and treatment responses. It is also common for individuals to have multiple chronic conditions simultaneously. Often, symptoms may overlap, and different disorders may contribute to the development of other chronic conditions. Chronic conditions can develop in any organ system, ranging in severity from mild to life-threatening. Chronic conditions last longer than 1 year and typically have ongoing symptoms that require continued medical monitoring or treatment. Chronic conditions may be genetic or acquired and may progress and change over a person’s life span. The majority of the acquired chronic conditions, such as heart disease, type 2 diabetes, obesity, and high blood pressure, are associated with a very short list of risk factors: smoking, excessive alcohol use, and a sedentary lifestyle. Recognizing symptoms of common conditions is crucial for nurses in day-to-day practice. Awareness of rare disorders will improve the nurse's ability to identify concerning symptoms early in the course of the disease.

Nurses must consider many aspects of an individual’s circumstances when caring for chronic conditions. Keeping in mind ethical considerations is crucial for providing patient-centered care. At-risk populations include pregnant women, children, older adults, and those with housing instability. These individuals may require more creative and individualized care based on their specific support needs. All individuals experience the effects of social factors, financial status, and environmental circumstances. These factors directly affect outcomes related to chronic conditions. Nurses must always consider family dynamics during patient care and include family in care planning if appropriate and preferred by the patient. Physical and functional assessments set the stage for nursing interventions focused on chronic disease management. Assessments may be head to toe or focused on specific concerns. These assessments must occur periodically to monitor for change over time. Education about therapies, medications, progression, and expectations is an ongoing process in chronic disease care. Nurses will also collaborate with other healthcare providers and ancillary specialties in providing supportive care. Supportive care addresses disease management and symptoms and consequences of the disease process.