Register      Login
Australian Health Review Australian Health Review Society
Journal of the Australian Healthcare & Hospitals Association
RESEARCH ARTICLE

Socio-environmental models of allied health disability support: an exploration of narrative experiences in the Australian National Disability and Insurance Scheme

Mitchell N. Sarkies https://orcid.org/0000-0001-7318-3598 A B C D G , Sarah Milne A B C E F and Annette Davis A B C
+ Author Affiliations
- Author Affiliations

A Allied Health and Community Services Workforce, Department of Health and Human Services, Melbourne, Vic. 3000, Australia.

B Department of Allied Health, Monash Health, Clayton, Vic. 3168, Australia. Email: Annette.davis@monashhealth.org

C School of Primary and Allied Health Care, Faculty of Medicine, Nursing and Health Sciences, Monash University, Frankston, Vic. 3199, Australia.

D Centre for Healthcare Resilience and Implementation Science, Australian Institute of Health Innovation, Macquarie University, 75 Talavera Road, NSW 2113, Australia.

E Murdoch Children’s Research Institute, Parkville, Vic. 3052, Australia. Email: sarah.milne@mcri.edu.au

F Department of Paediatrics, The University of Melbourne, Parkville, Vic. 3010, Australia.

G Corresponding author. Email: mitchell.sarkies@mq.edu.au

Australian Health Review 46(1) 64-69 https://doi.org/10.1071/AH21009
Submitted: 11 January 2021  Accepted: 15 May 2021   Published: 29 July 2021

Abstract

Objective The primary aims of this study were to explore: (1) manifestations of socio-environmental models of allied health support provision in the disability sector; and (2) narrative experiences of individual allied health professionals in the disability sector.

Methods A narrative qualitative study using interviews from a purposive sample of two allied health professionals working in the disability sector explored manifestations of socio-environmental models of allied health support provision and their experiences from case examples. The key informants had more than 10 years of experience in the disability support services setting.

Results Seven key themes exploring manifestations of socio-environmental models of allied health professional practice in the disability sector emerged: (1) dignity of risk; (2) models of care; (3) considerations when working in the supported person’s environment; (4) goal-oriented work; (5) informed choice and informed consent; (6) reactive and flexible plans; and (7) training and education role.

Conclusions Socio-environmental models of allied health support provision in the disability sector focus on empowering people with disability to achieve their goals. This may require displacement of cultural norms within the allied health professions.

What is known about the topic? Socio-environmental models of allied health support provision in the disability sector focus on empowering people with disability to achieve their goals.

What does this paper add? Displacement of cultural norms within the allied health professions may be needed to promote positive risk taking. Challenges for allied health professionals remain in navigating conflicting goals between clients and family members, empowering informed choice and consent, and working in uncontrolled environments.

What are the implications for practitioners? Adopting training and education roles for clients, family members and carers when implementing National Disability and Insurance Scheme plans may represent one of the many pragmatic and flexible approaches to achieve people’s goals.

Keywords: disability, allied health, National Disability and Insurance Scheme, occupational therapy, rehabilitation.


References

[1]  Smith-Merry J, Mellifont D, Gillespie J, Salvador-Carulla L. Recovery-oriented community mental health models: an Evidence Check rapid review brokered by the Sax Institute (www.saxinstitute.org.au) for the Agency for Clinical Innovation, 2016.

[2]  Canary HE. Creating Supportive Connections: A Decade of Research on Support for Families of Children with Disabilities. Health Commun 2008; 23 413–26.
Creating Supportive Connections: A Decade of Research on Support for Families of Children with Disabilities.Crossref | GoogleScholarGoogle Scholar | 18850389PubMed |

[3]  Greenfield S, Kaplan S, Ware JE. Expanding patient involvement in care: Effects on patient outcomes. Ann Intern Med 1985; 102 520–8.
Expanding patient involvement in care: Effects on patient outcomes.Crossref | GoogleScholarGoogle Scholar | 3977198PubMed |

[4]  Mastal MF, Reardon ME, English M. Innovations in disability care coordination organizations: integrating primary care and behavioral health clinical systems. Prof Case Manag 2007; 12 27–36.
Innovations in disability care coordination organizations: integrating primary care and behavioral health clinical systems.Crossref | GoogleScholarGoogle Scholar | 17387289PubMed |

[5]  Kingsnorth S, Lacombe-Duncan A, Keilty K, Bruce-Barrett C, Cohen E. Inter-organizational partnership for children with medical complexity: the integrated complex care model. Child Care Health Dev 2015; 41 57–66.
Inter-organizational partnership for children with medical complexity: the integrated complex care model.Crossref | GoogleScholarGoogle Scholar |

[6]  Mesidor M, Gidugu V, Rogers ES, Kash-Macdonald VM, Boardman JB. A qualitative study: barriers and facilitators to health care access for individuals with psychiatric disabilities. Psychiatr Rehabil J 2011; 34 285–94.
A qualitative study: barriers and facilitators to health care access for individuals with psychiatric disabilities.Crossref | GoogleScholarGoogle Scholar | 21459744PubMed |

[7]  Escorpizo R, Stucki G, Cieza A, Davis K, Stumbo T, Riddle DL. Creating an Interface Between the International Classification of Functioning, Disability and Health and Physical Therapist Practice. Phys Ther 2010; 90 1053–63.
Creating an Interface Between the International Classification of Functioning, Disability and Health and Physical Therapist Practice.Crossref | GoogleScholarGoogle Scholar | 20448104PubMed |

[8]  Stamm TA, Cieza A, Machold K, Smolen JS, Stucki G. Exploration of the link between conceptual occupational therapy models and the International Classification of Functioning, Disability and Health. Aust Occup Ther J 2006; 53 143–4.
Exploration of the link between conceptual occupational therapy models and the International Classification of Functioning, Disability and Health.Crossref | GoogleScholarGoogle Scholar |

[9]  Jarl G, Ramstrand N. A model to facilitate implementation of the International Classification of Functioning, Disability and Health into prosthetics and orthotics. Prosthet Orthot Int 2018; 42 468–75.
A model to facilitate implementation of the International Classification of Functioning, Disability and Health into prosthetics and orthotics.Crossref | GoogleScholarGoogle Scholar | 28905670PubMed |

[10]  Peterson DB. International Classification of Functioning, Disability and Health: An Introduction for Rehabilitation Psychologists. Rehabil Psychol 2005; 50 105–12.
International Classification of Functioning, Disability and Health: An Introduction for Rehabilitation Psychologists.Crossref | GoogleScholarGoogle Scholar |

[11]  Australian Institute of Health and Welfare. Allied health workforce 2012. National health workforce series no 5. Cat no. HWL 51. Canberra: AIHW; 2013.

[12]  Australian Institute of Health and Welfare. Hospital resources 2016–17: Australian hospital statistics. Health services series no 86 (Cat. no. HSE 205). Canberra: AIHW; 2018.

[13]  Sarkies MN, White J, Morris ME, Taylor NF, Williams C, O’Brien L, et al Implementation of evidence-based weekend service recommendations for allied health managers: a cluster randomised controlled trial protocol. Implement Sci 2018; 13 60
Implementation of evidence-based weekend service recommendations for allied health managers: a cluster randomised controlled trial protocol.Crossref | GoogleScholarGoogle Scholar | 29690882PubMed |

[14]  Mason J. Review of Australian Government Health Workforce Programs: Department of Health, Australian Government; 2013. Available at: https://www1.health.gov.au/internet/main/publishing.nsf/Content/review-australian-government-health-workforce-programs.

[15]  Wade DT, Halligan PW. The biopsychosocial model of illness: a model whose time has come. Clin Rehabil 2017; 31 995–1004.
The biopsychosocial model of illness: a model whose time has come.Crossref | GoogleScholarGoogle Scholar | 28730890PubMed |

[16]  Inter Government and Funding Strategies & Integrated Care. Service framework to improve the health care of people with intellectual disability. Sydney: NSW Ministry of Health; 2012.

[17]  Finkelstein V. Attitudes and disabled people: issues for discussion. New York: World Rehabilitation Fund; 1980.

[18]  Oliver M. Politics of disablement. Macmillan International Higher Education; 1990.

[19]  Hasler F. Developments in the disabled people’s movement. Swain J, editor. London: Sage; 1993.

[20]  Owens J. Exploring the critiques of the social model of disability: the transformative possibility of Arendt’s notion of power. Sociol Health Illn 2015; 37 385–403.
Exploring the critiques of the social model of disability: the transformative possibility of Arendt’s notion of power.Crossref | GoogleScholarGoogle Scholar | 25524639PubMed |

[21]  Shakespeare T, Iezzoni LI, Groce NE. Disability and the training of health professionals. Lancet 2009; 374 1815–6.
Disability and the training of health professionals.Crossref | GoogleScholarGoogle Scholar | 19957403PubMed |

[22]  Victorian Department of Health and Human Services. Supervision and Delegation Framework for Allied Health Assistants and the Support Workforce in Disability. 2018. Available at: https://www2.health.vic.gov.au/-/media/health/files/collections/policies-and-guidelines/a/allied-health-in-disability—supervision-and-delegation-framework.pdf?la=en&hash=17C8B0DA1306D5944508699B58349590B1BE4CCA.

[23]  Braun V, Clarke V, Hayfield N, Terry G, Liamputtong P. Handbook of research methods in health social sciences. Singapore: Springer; 2019.

[24]  Ylijoki O-H. Master’s thesis writing from a narrative approach. Stud High Educ 2001; 26 21–34.

[25]  Reis HT, Judd CM. Handbook of research methods in social and personality psychology. Cambridge University Press; 2000.

[26]  Bruner JS. Acts of meaning. Harvard University Press; 1990.

[27]  Riessman CK. Narrative analysis. Sage; 1993.

[28]  Creswell JW. Educational research: Planning, conducting, and evaluating quantitative. NJ: Prentice Hall Upper Saddle River; 2002.

[29]  Creswell JW, Poth CN. Qualitative inquiry and research design: Choosing among five approaches. Sage Publications; 2016.

[30]  Patton MQ. Qualitative evaluation and research methods. Sage Publications, Inc; 1990.

[31]  Patton MQ. Qualitative research and evaluation methods. Thousand Oaks, California: Sage Publications; 2002.

[32]  Butina M. A narrative approach to qualitative inquiry. Clin Lab Sci 2015; 28 190–6.
A narrative approach to qualitative inquiry.Crossref | GoogleScholarGoogle Scholar |

[33]  Creswell JW, Creswell JD. Research design: Qualitative, quantitative, and mixed methods approaches. Sage Publications; 2017.

[34]  Smith B, Sparkes AC. Narrative and its potential contribution to disability studies. Disabil Soc 2008; 23 17–28.
Narrative and its potential contribution to disability studies.Crossref | GoogleScholarGoogle Scholar |

[35]  Sarkies MN, Bowles K-A, Skinner EH, Haas R, Lane H, Haines TP. The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review. Implement Sci 2017; 12 132
The effectiveness of research implementation strategies for promoting evidence-informed policy and management decisions in healthcare: a systematic review.Crossref | GoogleScholarGoogle Scholar | 29137659PubMed |

[36]  Bradley EH, Curry LA, Devers KJ. Qualitative data analysis for health services research: developing taxonomy, themes, and theory. Health Serv Res 2007; 42 1758–72.
Qualitative data analysis for health services research: developing taxonomy, themes, and theory.Crossref | GoogleScholarGoogle Scholar | 17286625PubMed |

[37]  Janesick V. The Choreography of Qualitative Research: Minuets, Improvisations, and Crystallization. In Denzin N, Lincoln Y, editors. Strategies of Qualitative Inquiry. 2nd edn. Thousand Oaks, CA: Sage Publications; 2003. pp. 46–79.

[38]  Kitto SC, Chesters J, Grbich C. Quality in qualitative research. Med J Aust 2008; 188 243–6.
Quality in qualitative research.Crossref | GoogleScholarGoogle Scholar | 18279135PubMed |

[39]  Ibrahim JE, Davis MC. Impediments to applying the ‘dignity of risk’ principle in residential aged care services. Australas J Ageing 2013; 32 188–93.
Impediments to applying the ‘dignity of risk’ principle in residential aged care services.Crossref | GoogleScholarGoogle Scholar | 24028460PubMed |

[40]  Llewellyn G. The Image of the Profession in the Field of Developmental Disability: A Decade of Writing. Aust Occup Ther J 1990; 37 131–5.
The Image of the Profession in the Field of Developmental Disability: A Decade of Writing.Crossref | GoogleScholarGoogle Scholar |