Health needs of people with physical disabilities: a concept analysis
Disabled Persons. Health Services Needs and demand. Health Care (Public Health). Concept Formation. Nursing.
This study is a concept analysis of the health needs of people with disabilities, according to the model of Walker and Avant. The general objective was: to analyze the concept of health needs of people with disabilities using the Walker and Avant model. The specific objectives were: to identify and synthesize the concept of health needs of people with disabilities through an integrative review (IR); identify the attributes, antecedents, consequents and empirical referents of the concept of health needs of people with disabilities; elaborate a model case, a case-related and a contrary case of the concept of health needs of people with disabilities. The eight steps proposed by the Walker and Avant model were followed, namely: concept selection, conceptual analysis objectives, identification of possible uses of the concept, determination of the search criteria in the literature; concept identification; definition of the purpose of the analysis; verification of the uses of the concept; identification of defining attributes; example of a model case; determination of additional cases; definition of the antecedent and consequent terms to the concept; and determination of empirical references. For this study, the concept of the health needs of people with disabilities was selected, aiming to identify the main characteristics of these needs and whether they are applied to all people with any type of disability or can be specific to each group. A guideline protocol for an integrative review was then prepared. Data collection was carried out in the following databases: PUBMED, SCOPUS and Cumulative Index to Nursing and Allied Health Literature (CINAHL), accessed through the Capes Journals Portal, using descriptors indexed in the Medical Subject Headings (MeSH); and the Latin American Literature in Health Sciences (LILACS) and Scientific Electronic Library Online (SCIELO) databases, accessed through the Virtual Health Library (VHL) with Descriptors in Health Sciences (DeCS). The use of the concept of the health need of people with disabilities presented two training poles, the first one, the understanding about health needs, and the second, the understanding of who are disabled people. The most frequent antecedents were strongly associated with disability limitations, social vulnerabilities and weaknesses, lack of accessibility and disarticulation of health services. The defining attributes identified were the needs of health services, self-care activities, psychosocial support and specialized equipment. As a consequence of this concept, health commitment was predominantly found; poor access and contact with health professionals, medical consultations and services; social isolation and feelings of social devaluation and dependence for the maintenance of life, among others. This concept analysis made it possible to deepen the discussion about the health needs of people with disabilities, with a view to supporting health care for this group. To this end, it will contribute to the validation of the Health Needs Assessment Tool for physically, hearing and visual impairment (IANS - PCDFAV), which is under way