Community Case

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CASE INTRODUCTION: Allison Martin is a college-aged student with physical disabilities who is visiting the student health center today to discuss her health care needs as a young woman.

ROLES/CONCEPTS: College health; communication; legal issues; challenges related to the college experience

Case Part 1: Allison Martin, a 20-year-old freshman college student, is a paraplegic after a skiing accident that happened when she was 15 years old. She also has dyslexia, not related to the accident. She meets weekly with staff at the office for disability on campus to address her educational needs and accommodations. She is comfortable with her learning support counselor, Jane Logan. Allison shares with Jane that she is concerned about her female health issues, especially now that she is a college student living away from home. Jane refers Allison to the student health center.

  1. What concerns you about Allison?
    1. Allison’s disability can affect her phsysiologically and psychologically
    1. it is important that the college she chooses to attend is accommodating to her needs
    1. college can be a difficult adjustment so its important that Allison gets involved on campus to find her niche
  • Is there any other information you might need from Allison to best care for her?
    • Information that would reflect in the best care for Allison includes à
      • determining what activities interest her
      • discussing her concerns
      • determining whether sor not he is comfortable expressing her needs
      • educating her on health concerns amongst the college population
  • What are appropriate techniques for communicating with a patient in a wheelchair?
    • In order to make Allison feel more comfortable, it would be appropriate to sit at eye level. If a nurse chose to stand, she might feel as though she is being talked down to or scolded. It is also beneficial to ask open-ended questions and gain insight on what she knows and believes. If you do not build a rapport with patients, they might feel as though you are just sptting out educational facts and not fully understood their gaps, perceptions, and misconceptions.
  • What are the legal dimensions of providing a barrier-free environment for Allison?
    • The ADA was written to protect those with disabilities by prohibiting any form of discrimination in employment, government, public accommodations, transportation, telecommunications, and commercial facilities
    • This federal law protects those with disabilities (physical or mental impairment that substantially limits one or more major life activities with documentation of the impairment or being thought of to have the impairment)

Case Part 2: Allison Martin discusses her health care needs with Rachel Fuller, the nurse at the student health center. Allison shares that she is concerned about her female health issues, and that because of an unfortunate experience at the doctor’s office when she was younger, she has never been back to have her reproductive health care needs addressed. The nurse communicates supportively and therapeutically with Allison about her needs.

  1. Discuss the challenges that Allison may face as a college student with a physical disability.
    1. may face the challenge of not fitting due to her disability (paraplegic)
    1. might be limited in which activities she can participate in despite her interests
    1. might face difficulty in advocating for her needs to be met
  • How would you explore the topic of  “sexual health” with Allison?
    • Emphasize that it is normal for girls her age to explore their sexuality
    • Determine if she has ever been intimate/is currently intimate
      • # of partners
      • contraception methods
      • STIs
    • Discuss healthy relationships and what they entail
      • Provide resources
  • Compare and contrast the challenges that Allison may face as a college student with those of other female college students.
    • College Students à
      • tend to develop a sense of independence and find themselves during these 4 years
      • curious and tend to engage in risky behaviors such as unprotected sex, drugs, and alcohol
      • face body image issues and develop eating disorders
      • face peer pressure
    • Allison à
      • face body image issues
      • face discrimination
      • unable to participate in all the activities her peers do
      • struggle with friendships and relationships
      • going out and participating in activities requires more thought and planning than the average student
  • Identify some key strategies for communicating with a client with a disability.
    • listen to the concerns Allison has
    • discuss strategies to address these concerns
    • advocate for her if there is something she is lacking access to
    • empower her to advocate for herself
    • encourage participation in social activities
  • What resources are available to Allison to ensure that she is treated fairly with respect to her disabilities? HINT: Explore those at SCSU
    • course/testing accommodations
    • auxiliary aids, including sign-language interpreters, readers, and note takers
    • assistance with course selection and registration
    • supported designated course sections
    • access to assistive computer technology and alternate formats
    • liaison between students, faculty and university departments on disability related issues
    • referral to campus, community, and state services
    • provision of campus accessibility information and access to campus lift- equipped shuttle
    • adaptive equipment
    • Disability Resource Center (DRC)
    • Center for Adaptive Technology
    • Only one classroom on campus is inaccessible to persons with mobility limitations (Davis Hall-Room 102)
    • Outreach Unlimited is a student-run club that promotes disability awareness on campus
    • scholarships available to students with disabilities
  • In looking at the Public Health Intervention Wheel, what wedges of the wheel apply to Allison’s case and why?
  • Counseling à coping with the changes of being a college student
  • Consultation à consult with other schools to see what they have implemented
  • Collaboration à health services, educators, housing
  • Advocacy
  • Health Education
  • Surveillence