The purpose of this discussion is to describe some of the benefits and challenges to delivering community based participatory care to the disabled adult vulnerable population. The disabled adult population is at risk for poor health outcomes for many reasons. This population is at a disadvantage for health disparities due to low socioeconomic status and other disparities (Pender et al., 2015) because of the nature of their illnesses. As an advanced practice nurse, interventions should aim to reduce health inequalities among disabled adults. This is initially done by performing health assessments prior to formulating targeted health plans in partnership with each patient.
Areas of health assessment for the disabled population in which interventions should be directed includes health assets, behaviors, problems, health beliefs, and lifestyle strengths (Pender et al., 2015). Health assets can be viewed as factors that improve the life of disabled adults to maintain their health and therefore enhance well-being (Van Bortel et al., 2019). Health behavior ranges from involvement of disabled adult’s use of health services, or practices (Mahmoud, 2015). Disabled adults present with various health problems such as post residual stroke, deficits from spinal cord injury, and physical impairments (Gretschel et al., 2017). Additionally, morbidities such as hypertension or diabetes mellitus further complicate existing health impairments. Health beliefs of disabled adults can be assessed in the context of the health belief model (HBM), which helps to understand how an individual may view certain health related factors in making health decision. Health decision outcomes are related to individual perception of personal health effects (Pender et al., 2015). Lifestyle strengths such as persistence, positive attitude or coping mechanisms (Aungst et al., 2019) are important to assess in improving well-being.
Some community-based health promotion endeavors that can be aimed to improve quality of life for the disabled adults are providing educational or training programs (Van Bortel, et al., 2019) to enhance positive health behavior; improving physical activity by implementing a physical disability sport program (Kiuppis, 2016); implementing smoke cessation programs for impaired coping and other selfcare activities (Riegel et al., 2017); and providing disability rehabilitation services, which will allow improvement in daily life tasks or role functioning (Gretschel et al., 2017). Considerable benefits of implementing a community-based participatory research health promotion project with the disabled adults are improved functioning and skill development, decreased negative health behaviors and increased positive coping strategies, increased physical activity and general health, and increased selfcare participation (Riegel et al., 2017). Challenges that may hinder the success of health promotion project are related to the health disparities and inequities of the disabled adult population. Such challenges are health literacy (Pender et al., 2015) , poverty and lack of financial support, lack of access, lack of health insurance, (Mahmoud, 2015), lack of social support, and lack of motivation or interest (Aungst et al., 2019). Nonetheless, it is necessary for providers including the advance practice nurse to work hard at decreasing disparities and inequities in order to successfully implement changes at the community level to increase quality of life for disabled adults.
The advanced practice nurse should seek to implement community-based participatory care that is tailored to the disabled adult population. Because this population is at risk for poor health outcomes, seeking partnership to actively engage them in selfcare requires a comprehensive health assessment. While assessment involves health assets, health behaviors, health problems, health beliefs, and health related lifestyle strengths, assessment should be targeted to address all components of adult disability. Assessment data is imperative for successful implementation of health promotion endeavors that aims to improve quality of life for the disabled adult. Nonetheless, despite successful implementation, challenges to hindering success are evident due to health disparities and inequalities.
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