[Rehabilitation, Identity and Sense of Belonging: A Clinical Case].
[Rehabilitation, identity and sense of belonging: a clinical case].
Filed under: Rehab Centers
Sante Ment Que. 2012; 37(1): 119-34
Toliou A, Laugier F
Through the clinical narrative of a psychiatric patient in long term care, the article examines the rehabilitation process in adult psychiatry. After a brief presentation of the reception unit (post-cure follow-up for psychotic patients) and its focal areas of work, we present the progressive birth of multi-disciplinary care including nursing, individual psychiatric care and psychoanalytical group sessions. Finally, by exploring the group’s three-year history, we follow the patient’s evolution and propose certain hypotheses on the link between external habitat (institutional space) and internal habitat (intra- psychic space).
HubMed – rehab
[Care for chronic psychotic patients within the French public health system].
Filed under: Rehab Centers
Sante Ment Que. 2012; 37(1): 103-17
Laugier F, Toliou A, Kapsambelis V
This article examines rehabilitation of chronic psychotic patients as elaborated in France in the course of the last 60 years. After an overview of the historical and legislative aspects of the psychosocial rehabilitation movement, the article describes the different aspects that this terminology covers, and describes the various structures that currently exist in France. For ease of discussion, it develops the specificity of rehabilitation care as conceived by the Association Santé mentale in Paris’13ème arrondissement, created in 1958 as a pilot project of France’s future sectorisation. Our approach to care has been to favor the establishment of structures that include healthcare settings for less independent patients, to home-based care far from psychiatric care strictly speaking. Between these two poles, we have created both intermediate structures, but also developed a partnership with medical and social structures in order to favor transition of the institution to the city.
HubMed – rehab
[A psychiatrist working with homeless people: A commentary].
Filed under: Rehab Centers
Sante Ment Que. 2012; 37(1): 65-77
Plante MC
Testimony about the learning and working experience of twenty years of clinical practice with mental illness and homeless people; the author describes the therapeutic paradigm and clinical strategies the psychiatrist must learn and employ to encounter these patients, engage them in a treatment and rehabilitation towards a personalised life project to the recovery. The author then reviews some perspectives for the future care of this population.
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Is there a Valid and Reliable Assessment of Diagnostic Knee Arthroscopy Skill?
Filed under: Rehab Centers
Clin Orthop Relat Res. 2012 Dec 20;
Olson T, Koehler R, Butler A, Amsdell S, Nicandri G
BACKGROUND: The Basic Arthroscopic Knee Skill Scoring System (BAKSSS) has construct validity as an objective measure of arthroscopic proficiency when used to assess the task of performing arthroscopic meniscectomies on cadaver knees. The reliability of this instrument is unknown. QUESTIONS/PURPOSE: We asked whether (1) a simple modification of the BAKSSS would show construct validity similar to that in the initial BAKSSS study, (2) this assessment would be reliable, and (3) this assessment could be used as a high-stakes pass or fail test. METHODS: Twenty-three orthopaedic residents performed diagnostic knee arthroscopies on cadaveric knee specimens. Their competency was assessed by three live raters using the modified BAKSSS. Interrater reliability was assessed by comparing the scores given by each rater to each subject. RESULTS: The modified BAKSSS showed construct validity with junior residents achieving lower scores (mean score, 20) than senior residents (mean score, 33). The modified BAKSSS had an interrater reliability of kappa = 0.685-0.852. The modified BAKSSS had a kappa = 0.543 when used as a proficiency test for diagnostic arthroscopy. CONCLUSIONS: The modified BAKSSS is useful for assessing diagnostic knee arthroscopy proficiency. Future scoring systems should be designed to be generalizable so they can be applied to multiple procedures without the need for modification, allow for video-based assessment, and must be rigorously tested for reliability and other types of validity (eg, face validity, content validity, and criterion-related validity). CLINICAL RELEVANCE: Having a valid and reliable assessment of basic arthroscopic procedures may allow educators to more adequately evaluate individual residents and the effectiveness of various training modalities.
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