Home > RNJ > 2007 > September/October > Editorial: Developing a Global Perspective

Editorial: Developing a Global Perspective
Elaine Tilka Miller, DNS RN CRRN FAHA FAAN Editor

Whether you live in Australia, Thailand, Tanzania, Chile, the United Kingdom, or the United States, there will always be individuals who experience countless physical, cognitive, or emotional disabilities that require some form of rehabilitation. Within our global community, individuals possess similar anatomical and physiologic attributes, as well as disabilities, that demand prompt action. However, disparities in healthcare professionals’ skills, standards of care, resources, and public policies do not recognize national borders.

In the United States, rehabilitation has increasingly assumed a more prominent role in the care delivery process as higher survival rates from previously deadly or devastating acute and chronic diseases have occurred. However, the United States is somewhat isolated in this experience. From examining demographic data, we know that the focus on rehabilitation nursing has not been as important in other cultures. We also know that survival from many acute diseases lags far behind the United States. However, throughout the world, an estimated 600 million individuals live with disabilities (www.int/disabilities/introduction/en/index.html retrieved 6/23/2007). These numbers continue to rise with the growth of the world’s population, aging, malnutrition, birth defects, injuries, acts of violence at home and work, and survival from chronic diseases such as diabetes, cancer, and cardiovascular disease.

Over 80% of those with chronic disabilities live in low income countries and experience poverty that limits their access to basic healthcare services including rehabilitation services. Plus, persons with disabilities in many countries are excluded from the public health and other social policies that protect them. Research further identifies that the stigma and discrimination associated with having a disability puts these individuals at greater risk for targeted abuse (especially children), lack of social support, limited educational and employment opportunities, and participation in communities (International Rehabilitation Review, 2005).

So, what is the role of rehabilitation nursing? First, our profession must become more educated regarding global healthcare events and trends. Second, we must recognize that the World Health Organization (WHO) has assumed the role of enhancing the quality of life to promote and protect the rights and dignity of people with disabilities through local, national, and global efforts. For instance, the World Health Organization is concentrating on

  • developing normative tools including guidelines and a global plan of action to strengthen medical and rehabilitation services
  • advocating implementation of the United Nationals Standard Rules on the Equalization of Opportunities for Persons with Disabilities
  • facilitating the strengthening of specialized rehabilitation centers linking the services they offer to community-based rehabilitation
  • promoting strategies to ensure that persons with disabilities are knowledgeable regarding their own condition and that professionals support and protect their rights and dignity. (www.who.int/disabilities/care/en/index.html retrieved 6/23/2007)

Many rehabilitation nurses do not know that The United Nations’ General Assembly established December 3 as the International Day of Disabled Persons. The purpose of this distinct global date is to increase awareness and promote an understanding of disability issues and mobilize global support for dignity, the rights and equality of children and adults with disabilities. The 2007 theme is “Decent work for persons with disabilities.” Additional information can be found at www.un.org/esa/socdev/enable/disiddp.htm

As indicated by the efforts of the WHO and UN, the needs of persons with disabilities is receiving greater attention from the global community. However, this is simply not enough. With the anticipated growth of persons with disabilities worldwide, rehabilitation nurses must assume a leadership role by becoming more knowledgeable regarding global efforts to improve the quality of life and care of patients. In addition, rehabilitation nursing must move its emphasis to a global perspective. But, just how can this be done?

We must become aware of healthcare issues and disparities in other countries. Begin by going to the WHO and UN Web sites. We must publish more research that is internationally focused so that our understanding of international issues is more fully developed. We must be active in international conferences and Internet exchanges that include rehabilitation nurses from other countries and cultures. We must share “best practices” with nurses across the globe. This does not mean that the United States is the gold standard, but that we participate in this process and communicate regularly to share assessment and intervention strategies as well as care outcomes. We must travel more to other cultures and countries to observe firsthand how rehabilitation nurses practice in different settings. We must learn from this experience and bring new ideas and thinking to our own country while sharing our own thinking and observations with other nations.

Globalization of rehabilitation nursing will help our profession to become more astute and responsive to the unique dimensions of our practice. Plus, much can be learned as we share the knowledge, skills, and research that transcend geographic boundaries.


International reports (2005). International Rehabilitation Review, 55, 2, 7.

World Health Organization (WHO). Disability and Rehabilitation Action Plan 2006-2011. Retrieved July 1, 2007 from www.who.int/disabilities/publications/dar_action_plan_2006to2011.pdf