A CONCEPTUAL-MODEL OF INDEPENDENCE AND DEPENDENCE FOR ADULTS WITH CHRONIC PHYSICAL ILLNESS AND DISABILITY

This paper presents a conceptual model of physical independence and de pendence as it relates to adult onset, chronic physical illness and di sability. Physical independence and dependence are presented as two se parate, continuous, and multiply determined constructs, and illustrati ons are provided of situations where people can be independent, depend ent, not independent, or experience imposed dependence. The paper also discusses potential determinants of physical independence and depende nce, including different domains of disability, the role of subjective perceptions, demographics, the physical and social/political environm ents, personal resources, attitudes and coping resources, illness and efficacy appraisals, and the nature of the assistive relationship. The paper extends work on physical independence and dependence by synthes izing the findings from previous studies and incorporating the finding s from other relevant areas of research into the area. It also expands on the concepts of physical independence and dependence, as well as t heir determinants, and relates independence and dependence to other ou tcomes of interest such as service delivery. (C) 1998 Elsevier Science Ltd. All rights reserved.