Disablement observed, addressed, and experienced: integrating subjective experience into disablement models.

Abstract

Although subjective experience is critical to full comprehension of disablement, it has yet to be integrated into models in a systematic and theoretically grounded way. This article presents a framework for modelling disablement that includes both objective and subjective features. The framework is based on a novel integration of: (1) perspectives on disablement; (2) the contexts within which disablement occurs; and (3) interaction among these perspectives and contexts. The framework is developed using nomenclature derived from the WHO's International Classification of Impairments, Disabilities, and Handicaps (ICIDH). Although ICIDH terminology is used, the article's integration of ideas can as well be applied to other disablement nomenclatures and models. The framework offers a conceptual background for innovative clinical, policy, and research responses to disablement, as well as for further development of disablement theory and models.