Posts in this category concern some aspect of models of illness, and frameworks used with rehabilitation. The biopsychosocial model and the biomedical model will be predominant, but other related models may be included.
The biopsychosocial model of illness was born in 1977, with a reasonably well-documented gestation. Its growth and development are easily tracked, showing changes and improvements, and anyone can quickly discover the model. In contrast, the medical model, better termed the biomedical model, has been gestating and growing since about 1500, when the Scientific Revolution started. …
In 1978, I submitted my first paper to the British Medical Journal. It concerned what we now refer to as functional disorders, the phenomenon of illness with no identified disease causing it. I have been interested since. A recent editorial by an Oxford colleague, Anton Pick, discussing whether patients with Long Covid had a functional …
Hospitals are a part of the healthcare system, but is rehabilitation healthcare? The UK Department of Health, responsible for all healthcare and not just hospitals, promotes the idea that a patient only has a right to reside in a hospital until specific criteria are met. The requirements are mainly physiological and do not consider the …
At 02.00 hrs on November 29th, I had an epiphany, “a moment of sudden and great revelation or realisation”. [OED] For many years, I have emphasised a distinction between assessment as a process and assessment as a measure (e.g. “the outcome assessment was the Rivermead Mobility Index”), and I have suggested that both should be …
“Rehabilitation is a way of thinking, not a way of doing.” I have written two editorials extolling this approach, but I have recently realised that I have not explained the specific “way of thinking”. This omission struck me as I was writing some new pages for the site (not yet published) on training in rehabilitation …
In 2007 Peter Halligan and I asked, “Is it time to rehabilitate convalescence?”. No one answered until, in 2022, Gavin Francis also challenged healthcare practice in his book, “Recovery, the lost art of convalescence.” He argues that “from time to time, we all need to learn the art of convalescence”. The medical literature, however, publishes …
In 1980 I started a three-year project, a large (n = 700+) controlled clinical trial investigating whether a community stroke rehabilitation team would reduce the use of hospital resources. My results found no effect. Twenty years later, I was still interested in community rehabilitation and, with Pam Enderby, published the results of a survey she …
Is frailty a helpful concept within the rehabilitation context? I asked myself this question after seeing a recent paper on people with multiple sclerosis that concluded that there was “a significant relationship between frailty and history of falls in multiple sclerosis, independent of age, sex, and disease severity.” Frailty is widely used but without a …
What is a person’s ‘Rehabilitation Potential’? Often this question is asked by one clinician of another about a patient. Still, there is a second interpretation, “What do we mean by Rehabilitation Potential when we ask that question?” I will discuss these questions, but before doing so, I will consider two further crucial questions, “Can we, …
These are dangerous and difficult words used in many powerful ways: if considered disabled, you get disability benefits; if you are considered sick, you may get sickness benefits. A disease may make you eligible for a critical illness policy payout. Labels incorporating any of these words can significantly impact your life. Unfortunately, the interpretation of …
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