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Ce reprezinta o abordare interdisciplinara in realizarea programului kinetic?

Omul este o fiinta complexa, fapt care ridica o serie de provocari in actul

recuperator.In prezent, acesta trebuie vazut din mai multe perspective, printre acestea

regasindu-se arii precum pshihologia, medicina, religia si sprijinul comunitatii locale.

Numai luand in considerare toate aceste aspecte putem asigura un act recuperator decalitate in urma caruia pacientii sa se poata integra usor in societate. De asemenea, s-a dovedit

ca o abordare interdisciplinara asigura rezultate mult mai bune decat o abordare

unidirectionala.

Un prim avantaj al unei abordari interdisciplinare in cadrul kentoterapiei este

reprezentat de posibilitatea sporita de depistare a problemelor de sanatate in stadiul incipient.

Acest lucru este posibil prin colaborarea specialistilor din diverse arii ale societatii, care pot

observa din timp problemele de sanatate ale persoanelor cu care interactioneaza si le pot ghida

catre un specialist care poate incepe tratamentul profilactic sau propriu-zis.

Din punct de vedere profilactic, kinetoterapeutul poate evalua starea de sanatate a

pacientului si il poate indruma care un medic specialist, alaturi de care va incerca sa asigure

un tratament de calitate pacientului. De asemenea, pe durata tratamentului pacientul arenevoie de sprijin emotional pentru a putea trece mai usor peste situatia dificila cu care se

confrunta. Acest sprijin este asigurat, de cele mai multe ori, de familie si prieteni, care ajuta

pacientul sa fie optimist si sa depaseasca momentul. Acest sprijin poate veni si din partea

unui pshiholog care sa evalueze periodic starea pshica a pacientului, precum si sa-l motiveze

in procesul recuperator, deoarece un aspect foarte important in acest demers il are motivatia

pacientului pentru a se vindeca.

Pe plan international, termenul de echipa interdisciplinara a luat amploare in ultimii 20

de ani. Acesta a aparut din nevoia de eficientizare a actelor medicale, precum si din

considerente economice.

Abordarea interdisciplinara a aparut ca necesitate de imbunatatire a tratamentelor

oferite de metodele clasice existente la momentul respectiv. In acest proces, sistemele

medicale au trecut prin modelul medical, multidisciplinar si interdisciplinar, iar in acest sens

exista o tendinta de abordare a unui model transdisciplinar.

Modelul initial, medical, este constitutit dintr-o echipa simpla, formata din medic-

asistent-kinetoterapeut. In aceasta echipa, medicul controleaza intreaga echipa, precum si

actiunile celorlalti membri. Comunicarea in cadrul acestui tip de echipa se realizeaza doar pe

verticala, deoarece exista o structurare ierarhica care de cele mai multe ori impiedica

exprimarea punctelor de vedere ale celorlalti membri.

Sheehan, Robertson si Ormond(2007) au observat ca prin acest mod de lucru apar de

multe ori neintelegeri in cadrul echipei, deoarece intreg tratamentul se invarte in jurulmodului in care medicul decide sa intervina. Prin urmare, aceasta abordare nu este la fel de

eficienta in comparatie cu celelalte modele.

Abordarea multidisciplinara a aparut din nevoia de a eficientiza actul terapeutic si

pune in centrul ariei de interes pacientul. In vederea tratamentului, acesta beneficiaza de

ajutor din partea a diversi specialisti, precum medicul, asistentii, nutritionist, pshiholog,

kinetoterapeut, servicii sociale si terapie ocupationala.

Chiar daca acest mod de abordare a tratamentului abordeaza intr-un mod mult mai

amplu dificultatile cu care se confrunta pacientii se confrunta cu o lipsa de comunicare

laterala intre specialisti, deoarece acestia nu colaboreaza intre ei pentru a decide ce este in

avantajul pacientului si sa isi imparta sarcinile care ar duce la eficientizarea tratamentului.

Comunicarea se realizaeza predominant vertical, fiind dictata de pacient.

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Abordarea interdisciplinara vine sa rezolve aceasta problema. Acest model de

organizare a echipei de specialisti isi propune sa se axeze pe comunicarea laterala intre

specialisti, care vor analiza si decide impreuna cele mai eficiente metode te tratare a

bolnavului. Pacientul va comunica in continuare vertical cu specialistii, dar acestia vor forma

un totunitar menit sa eficientizeze actul terapeutic. O astfel de echipa interdisciplinara este

formata din medicul specialist, kinetoterapeut, pshiholog, nutritionist,asistent, nutritionist,asistent social, precum si un specialist in reeducare verbala si terapie ocupationala.

Recent, din considerente preporderent economice, conceptul de echipa

interdisciplinara tinde sa evolueza catre transdiciplinaritate. In acest caz, specialistii din

diverse arii sunt nevoiti sa cunoasca si atributele altor membrii ai echipei. Acest proces este

bun doar din punct de vedere al costurilor, deoarece calitatea tratamentului este diminuata de

lipsa de aprofundare in domeniu a specialistilor din diverse arii, acestia fiind nevoiti sa

dobandeasca si cunostintele celorlalti membri.

Modelul interdisciplinar, desi cel mai eficient din punct de vedere al calitatii

tratamentului, ridica o serie de provocari in randul specialistilor. Acestia trebuie sa poata lucrain echipa, sa fie capabili sa rezolve conflictele ce pot aparea intre acestia, precum si sa

respecte munca celorlalti membrii implicati in tratarea pacientului.

Cel mai important aspect al unei echipe interdisciplinare este reprezentat de

comunicare. Specialistii din diverse arii trebuie sa aiba un limbaj cat mai accesibil in cadrul

echipei, deoarece limbajul de specialitate specific unei arii nu poate fi inteles de ceilalti

membri. In acest sens, specialistii trebuie sa fie toleranti cu ceilalti membrii si sa actioneze in

interesul pacientului.

Interdisciplinary collaboration, patient education

The importance of interdisciplinary involvement by the total health care team is central to

effective patient care and is an area of JCAHO focus. Although some agencies have achieve

excellent interdisciplinary collaboration, lack of communication among disciplines often

creates barriers. Inadequate communication can lead to disagreements over turf and an

inability to collaborate, both between individuals and in team conferences. Patients are often

baffled by various team members who repeat instructions already taught by someone else.

The need to move patients through the health care system in an effective and cost-effective

way means that nurses and other health care professionals must learn ways of providing

patient teaching collaboratively.

Because of nursings continuous and visible presence at the patients side, nurses are in the

unique position to provide leadership for patient education and to capitalize on the strengths

of each discipline for the patients ultimate benefit. Understanding the significant

contributions that other health care professionals can make to patient teaching is an important

part of the nurses knowledge base. To do this, the nurse needs an accurate understanding of

the expertise of each member of the team.

Physicians help patients understand the health care problem and the treatment plan.

Physicians report that they depend on nurses to help reinforce the teaching they do. Nurses are

often asked follow up questions by patients and families, especially when physician

explanations are not in terms the patient understands or when patients and families haveadditional questions. Collaboration with physicians increases with good communication and

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effective documentation. Physical therapists teach patients and families about mobility and

how to perform functional activities safely. Occupational therapy teaching focuses on how to

make adaptations that enable patients to be as independent as possible in activities of daily

living. Physical and occupational therapists depend on nurses to educate patients about their

disease condition and to reinforce instructions they give, particularly regarding carrying

through with positioning, transfers, and the use of adaptive devices. Nurses activeparticipation in formal team meetings and informal meetings on patient units or by telephone

maximizes the contributions of both disciplines. Dietitians teach patients and families about

therapeutic diets. They assess the patients usual dietary patterns and plan with the patient and

family how the customary diet can be modified to achieve health management goals.

Dieticians depend on nurses to reinforce the importance of following the dietary plan and

providing feedback about patient participation. Pharmacists teach patients how drugs work in

their bodies, what the medications are for, why its important to take them, how to store them,

and how to avoid drug interactions with other medications and food. Pharmacists often

depend on nurses to reinforce information they have given patients. Social workers serve as

an important liaison between the hospital staff and the community. Social workers coordinate

referrals to many different agencies and resources, and provide emotional support to patientsand families. The efforts of social workers are maximized when nurses are able to provide

specific information about the patients home situation.

In well-functioning interdisciplinary teams, team members view nurses as their eyes and

ears- to provide feedback about patient participation, to share information that may help

team members plan and adjust goals, and to reinforce and follow through with teaching they

have provided. In turn, nurse members of top performing teams communicate superbly, both

orally and in writing. They keep communication channels open, are active participants in team

conferences, and provide excellent and current progress notes about patient teaching results so

that other team members are kept continuously informed. Effective teams often cite specific

characteristics that allow them to work well together. Some of the characteristics of effective

interdisciplinary teams include:

Good communication, both verbal and written, facilitated by planning meetings,patient care conferences, telephone consultation, good documentation, and the

willingness to go out of the way to make sure communication takes place

Mutual respect among disciplines, recognizing respective areas of expertise, knowingones limits, and teaching each other

A desire to work as a team and recognition of a common goal

Who are members of an interdisciplinary team? What is their role?

Depending on an individual's age and disability, the exact composition of the interdisciplinary

team will vary. An interdisciplinary team consists of the family and professionals who are

engaged in supporting the individual. The team typically includes at minimum the individual

with severe communication disabilities, a family member or guardian, a speech-language

pathologist, and a teacher (general or special education). Other members may include, but are

not limited to, an occupational therapist, physical therapist, general education and/or special

education teacher, direct care staff, employer/job coach, psychologist, and social worker.

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The ideal interdisciplinary service delivery model requires that participants share a common

perspective on communication. This shared perspective should include a broad understanding

of communication including that it is a shared social skill and that it have effects on other

people, and can be nonspoken or spoken and nonsymbolic or symbolic The role of the

interdisciplinary team is to work cooperatively to provide discipline-specific assessment and

intervention, although some cross-disciplinary activity may occur as team members

collaborate in the delivery of communication services and supports. They discuss their

findings and activities to seek consensus and to develop goals and plans as a team.

Sometimes members of the team may differ about the recommended communication

intervention approach for an individual. In these cases, professionals should be guided by the

scope of practice and the evidence base. The team must work together to resolve their

differences and build consensus so that that individual receives the communication services

and supports he or she needs. Sometimes the team may want to seek outside consultation

when the team remains divided about an intervention approach or recognizes it doesn't have

the requisite expertise represented within the group.