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Abstract: The aim of this article is to present the Theory of Self-Care Management for Vulnerable Populations, a middle range theory that focuses on enhancing health status and quality of life in vulnerable populations such as adults with Sickle Cell Disease (SCD). The model describes significant factors that may predict health status and quality of life (QOL) in vulnerable populations. This article reviews the Theory of Self-Care Management for Vulnerable Populations using research related to adults with SCD.
Key Words: Vulnerability, Self-Care, Quality of Life (QOL)
Vulnerability and vulnerable populations are significant concepts in today's health care system. Vulnerable populations are social groups who experience health disparities as a result of a lack of resources and increased exposure to risk (Anderson, Fullilove, Scrimshaw, Fielding, Norman, & Zaza, 1999; Flaskerud & Winslow, 1998). Diverse, vulnerable groups are most often comprised of people of color, people living in poverty, and people marginalized by sexual preference, immigrant status, religion, or creed (Flaskerud, et. al., 2002). Vulnerable groups also include high-risk mothers and children, non-English speaking individuals, people with AIDS, and homeless families (Aday, 1997; Shi, 2000).
Definition of Vulnerable Populations
The Agency for Health Care Research and Quality (AHRQ) defines vulnerable populations as those who are made vulnerable by their financial circumstances or place of residence, health, age, personal characteristics, functional or developmental status, ability to communicate effectively, and presence of chronic illness or disability. AHRQ asserts that vulnerable populations may be less able than others to care for themselves during rapidly changing healthcare and may incur different health outcomes related to unwanted disparities and barriers to care. Defining vulnerable populations in terms of health disparity, the National Institutes of Health (NIH) state that they are populations where a significant difference has been identified in the overall rate of disease incidence, prevalence, morbidity, mortality, and survival rates among specific population groups as compared to health status of the general population. (Trans NIH Work Group, 1999).
A review of the evolution of knowledge about vulnerable populations in the 1990s indicates that escalation of costs associated with health care delivery and a growing number of people without access to health care stimulated political interest in addressing challenges faced by vulnerable populations (Flaskerud, et al., 2002). In essence, the well...