Moving to a Holistic Model of Health: The Need to Join Person and Environment for Persons with Mobility Disabilities

The purpose of this study was to explore the concepts of health among people with mobility disabilities in order to develop a new holistic model of health and to identify implications for social work practice. A qualitative study based on face-to-face interviews with people with mobility disabilities was conducted. Nine consumers and nine social workers with mobility disabilities participated in the study. Social constructionism, heuristic paradigm, empowerment paradigm, and strength perspectives were used to form conceptual foundations to guide the study. Study participants' holistic descriptions of the concept of health encompassed five domains: biological/physical, mental/emotional, financial, relationships with others, and spiritual. Participants described health as harmony among these five domains. Harmony indicates that all five domains contribute to the concept of health, and that each domain is related to the others. Participants also viewed disability and health as an interconnected whole, not separate concept. The conceptual model developed in this study expands on the existing concepts of health by considering multiple factors at the personal and environmental levels, as well as interactions among the factors and between the levels. The personal level has five domains: biological/physical, mental/emotional, spiritual, financial, and relationships with others. The environmental level has also five domains: relationship with others, financial, social programs, social attitudes toward peoplewith disabilities, and physical environment. All factors under the personal and environmental levels also affect each other. The holistic concept of health for people with disabilities is not solely a part of the person, but rather is a function of the interaction between the person and their environment. The study demonstrated that people with disabilities have strength and resiliency, and health is an attainable goal for them, particularly when environmental and cultural barriers are addressed. The focus of social work practice should be the removal of those barriers encountered by their consumers with disabilities, as well as, the enhancement of internal factors that facilitate well-being.