An investigation of multidisciplinary complex health care interventions – steps towards an integrative treatment model in the rehabilitation of People with Multiple Sclerosis

Abstract

BackgroundThe Danish Multiple Sclerosis Society initiated a large-scale bridge building and integrative treatment project to take place from 2004–2010 at a specialized Multiple Sclerosis (MS) hospital. In this project, a team of five conventional health care practitioners and five alternative practitioners was set up to work together in developing and offering individualized treatments to 200 people with MS. The purpose of this paper is to present results from the six year treatment collaboration process regarding the development of an integrative treatment model.DiscussionThe collaborative work towards an integrative treatment model for people with MS, involved six steps: 1) Working with an initial model 2) Unfolding the different treatment philosophies 3) Discussing the elements of the Intervention-Mechanism-Context-Outcome-scheme (the IMCO-scheme) 4) Phrasing the common assumptions for an integrative MS program theory 5) Developing the integrative MS program theory 6) Building the integrative MS treatment model. The model includes important elements of the different treatment philosophies represented in the team and thereby describes a common understanding of the complexity of the courses of treatment.SummaryAn integrative team of practitioners has developed an integrative model for combined treatments of People with Multiple Sclerosis. The model unites different treatment philosophies and focuses on process-oriented factors and the strengthening of the patients’ resources and competences on a physical, an emotional and a cognitive level.

Use of Complementary and Alternative Medicine among People with Multiple Sclerosis in the Nordic Countries

“…Based on knowledge from a large Danish research project that took place from 2004 to 2010 within the Danish Multiple Sclerosis Society and investigated treatment collaboration between conventional and complementary practitioners [27, 28, 31–33], a questionnaire was developed, tested, and validated using cognitive interviews as well as assessments by an expert group of Nordic neurologists [34]. The questionnaire was developed in Danish and translated into the Nordic languages, then back to Danish by health professionals with Danish or the other Nordic languages as native language/second language, respectively.…”

“…Internationally, study results indicate that the prevalence of CAM use among people with MS ranges from 41% in Spain to 70% in Canada and 82% in Australia [8, 21, 22]. The reasons for CAM use vary from treatment of concrete symptoms [4, 5, 13, 23, 24] to bodily exploration and development of coping strategies [18, 25–28], and CAM treatments are most often used in combination with conventional treatment [17, 22, 29, 30]. In Denmark, results of previous small-scale and often unpublished studies suggest that the prevalence of CAM treatment use is fairly consistent among individuals with MS, ranging from 48% (1998) and 54% (2002) to 52% (2007) [4–6] (The studies are not entirely comparable due to differences in the wording of the survey questions.).…”

People with multiple sclerosis in Denmark who use complementary and alternative medicine—Do subgroups of patients differ?

“…It was based on data from the before-mentioned large Danish research project by The Danish MS Society that took place between 2004 and 2010 and investigated treatment collaboration between conventional and complementary practitioners [38][39][40][41][42]. A questionnaire was developed, tested and validated by use of cognitive interviews as well as assessments from an expert group of neurologists [43].…”

Neurorehabilitation in Multiple Sclerosis – Resilience in Practice

“…[86][87][88][89][90] This team should involve a neurologist trained in rehabilitation medicine, and multiple other therapists including speech therapists, psychologists, MS nurses, orthopaedic technicians, physiotherapists, ergotherapists and social service representatives (see Figure 2). All should interact and operate in a coordinated way and work to an integrated clinical care pathway.…”