Carol M. Davis

Philosophical foundations of interdisciplinarity in caring for the elderly, or the willingness to change your mind

The experience of team assessment of an elderly person is examined closely, focusing on the usual taken-for-granted ways in which health professionals interact with one another. The process of interdisciplinarity is distinguished from multidisciplinarity and from transdisciplinarity and the five elements of interdisciplinarity are outlined. A case study follows illustrating how these similar processes would be carried out with a given client. The suggestion is made that multidisciplinarity is rarely useful but that true interdisciplinarity at its best provides the client with a thorough evaluation and plan, and highly integrated care. Transdisciplinarity is briefly identified as a process whereby professional boundaries not only blend for the good of the whole, but in which also team members feel empowered by the contribution of other colleagues.

Functional Independence Measurement (FIM) of Patients Receiving Easy S treeta-A Retrospective Study

The objectives of this study were to (1) determine the types of patients who utilized the Easy Street facility and (2) compare the functional independence levels at discharge of patients who utilized Easy Street to that of patients who did not receive this treatment. This study utilized a retrospective chart review to collect data on a group of patients who were seen by physical therapy during a three-month period shortly after the introduction of Easy Street and on a second group of patients who were seen the previous year prior to its introduction. Controlling for length of stay, it was anticipated that patients who utilized Easy Street as part of their treatment protocol would demonstrate higher levels of independence upon discharge as measured by the Functional Independence Measure (FIM) than would patients who did not utilize Easy Street as part of a therapeutic protocol. A total functional ability-score was calculated from five FIM items dealing with transfers and locomotion at admission and dischar...

More Questions Than Answers

To the Editor: I just completed reviewing the October issue of Physical Therapy and find myself both excited and frustrated. How exciting that the Philadelphia Panel has released these important data on the evidence of the efficacy of our most common treatments for very common musculoskeletal problems. How frustrating to learn that so few of the modalities that we have come to believe in actually show evidence of efficacy in controlled trials.nnI am left with more questions than answers, and I expect I am not alone. In our attempt to show evidence of efficacy, could we be too narrow in defining what constitutes evidence? Are we too narrow in measuring our outcomes? How much of what we observe as evidence when our patients improve might be due to a placebo effect? And how detrimental is the randomized controlled trial in identifying a placebo effect? Dr Anne Harrington of the Department of the History of Science at Harvard University suggested that only when our research began to measure very real physical effects of placebo did placebo come to be seen as a confounding variable in research.1 I contend that some cultures (eg, certain Asian cultures) tend to view nonspecific benefits as being part of the individuality of the healing process. I also would argue that some cultures do not even try to control for variables or to separate the physical from the metaphysical. Perhaps they are not driven by showing cause and effect in health care.nnThe National Institutes of Health is currently funding studies that are looking at the placebo effect.2 According to the Web site for the National Center for Complementary and Alternative Medicine of the National Institutes of Health (http://nccam.nih.gov/fi/concepts/rfa) there are 2 program announcements inviting applications addressing different aspects of placebo. Data have shown …