In May 2021, Dr Sabena Yasmin Jameel published her University of Birmingham PhD thesis on Enacting Phronesis in General Practitioners. John Launer wrote about it on November 2nd, and I saw a tweet about his article. She has studied wisdom in general practitioners, but the findings apply to all healthcare professionals. Indeed, rehabilitation professionals should …
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 …
This blog post is based on an extensive systematic review that generated a sound, theoretically-based model of person-centred rehabilitation. I can only develop some central themes and messages here. For more details, read the article. (here) The authors conclude that person-centred rehabilitation “is a way of thinking about and providing rehabilitation services “with” the person.” …
The diagnosis and management of patients with prolonged disorders of consciousness is an area of expertise acquired by rehabilitation specialists starting in 1992 with the Bland case. There were few developments until 2010. Change accelerated, culminating in 2018 with a Supreme Court ruling that removed the requirement to involve the Court of Protection in every …
Prolonged disorders of consciousness (PDOC); history and update. Read More »
Rehabilitation usually promotes itself as holistic, considering the patient as a whole and being patient-centred. Using the biopsychosocial model should indeed enforce a holistic, patient-centred approach. (here) Nevertheless, there are counter-forces at play, forces that we sometimes encourage. The primary countervailing power is a desire to categorise, classify, and develop small specialise treatment programmes. For …
Teams use many different words to describe themselves. A group recently asked me to help them decide whether they are a multidisciplinary or an interdisciplinary team. The background information provided perfectly illustrated the difficulty in defining the team, as illustrated in this figure. (here) The question prompted me to write this blog post to show …
Multidisciplinary, Interdisciplinary, or Transdisciplinary? Read More »
PDOC stands for Prolonged Disorder of Consciousness; the term covers two previously defined states: the vegetative state, and the minimally conscious state. This post considers the question, “Does a person in a prolonged disorder of consciousness experience pain?” This question covers both pain caused by care or treatment, and also pain arising secondary to consequences …
On Friday, 2nd July 2021 (at 05.00 hrs), I participated in a debate organised by Professor Barbara Wilson and hosted virtually in Melbourne, Australia. The discussion concerned the use of goal attainment scaling (GAS). Two speakers supported its use clinically, in audit, and in research; two opposed it. At the outset, only 4% of listeners …
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