Perceptions of wellness from adults with mobility impairments

The idea that an individual can have a disability and be well at the same time is a relatively new one (Krahn, 2003). According to Drum, Krahn, Culley, and Hammond (2005), "Until recently, disability was presumed equivalent to illness, and it elicited all the associations of dependence, lack of productivity, and physical and sexual inactivity that are incumbent to the notion of illness" (p. 29). However, individuals with mobility impairments are just as interested in achieving and maintaining a healthy lifestyle as individuals without disabilities. For the 50 million plus Americans with disabilities (Brault, 2012), maintaining health and wellness and minimizing secondary conditions are important contributors in decreasing impairment as a result of secondary conditions. According to Kailes (2005), "Unfortunately health promotion and preventative health care has received little attention, in part due to the strong perception that health and disability are mutually exclusive" (p. 2). Because of a limited number of resources, people with mobility impairments have a difficult time obtaining helpful information regarding the types of exercises best suited for their specific limitation. This is a major concern when one takes into account that physical activity is credited with having the ability to decrease depression rates and increase an individual's quality of life. Furthermore, many misconceptions and nonconstructive attitudes exist about older adults and those with disabilities concerning quality of life and life satisfaction (Rosenberg, Bombardier, Hoffman, & Basia, 2011). According to Hiss and Rauworth (2007), professionals such as doctors, nurses, and fitness and wellness instructors "need to acquire the knowledge to dispel and redirect these misconceptions as well as treat clients with the respect and sensitivity needed to provide a high-quality service" (p. 42). This knowledge includes "understanding activity limitations; knowing the Americans with Disabilities Act (ADA) as it relates to recreation facilities; and developing an awareness of how people with health considerations may differ from one another and from the general public" (Hiss & Rauworth, 2007, p. 42). Although good health habits, including diet and exercise, do not guarantee a long life, they may increase one's chance for leading a higher quality life (Kailes, 2005). A review of the literature revealed that although there are many studies that investigate wellness programs for adults without disabilities, children with disabilities, and older adults (Davis et al., 2009; Groff, Lawrence, & Grivna, 2006; Piggot, Paterson, & Hocking, 2002), research that examines wellness among adults with mobility impairments is lacking. Our aim in this study, therefore, was to begin to fill this gap by exploring the lived experiences of wellness from adults with mobility impairments. Defining Disability and Wellness According to the ADA (1990), the term disability means that (a) there is a physical or mental impairment that substantially limits one or more major life activities, (b) there is a record of such impairment, or (c) the individual is considered to have such impairment. Major life activities under this definition include but are not limited to the ability to learn, speak, walk, see, hear, breathe, work, or care for oneself. This definition is consistent with the biopsychosocial model of disability, which posits that the interaction of biological, psychological, and social factors can influence the course and outcome of one's health and wellness (Halligan & Aylward, 2006). The biopsychosocial model has served as the general framework to guide theoretical and empirical exploration since 1977 (Armitage & Conner, 2000). Because the definition is subjective and continuously evolving, defining wellness is difficult. However, there does seem to be agreement about some general characteristics found within most definitions. …