Abstract
A significant proportion of the population has a disability and people with more severe disabilities are likely to have contact with district nursing and other support services. Well-organized multidisciplinary rehabilitation services yield substantial benefits to the individual patient and their family (Wade and de Jong, 2000), and the specialty of rehabilitation is growing in the wake of practical innovations and increasing evidence of the merits of specific interventions. However, the most significant development has been recognition of the psychological and sociocultural dimensions of disability, seeing disability less as an illness than as a personal and social experience of impaired function, which impacts on participation. This approach allows the emergence of quality of life as an important care outcome. More work will need to be done to give equal weight to subjective experiences as compared to quality of life quantified using standardized instruments, but this conceptual shift has helped rehabilitation services to argue convincingly for a more equitable distribution of health care resources.
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