PHYSICAL AND REHABILITATION MEDICINE AND SELF-MANAGEMENT EDUCATION A COMPARATIVE ANALYSIS OF TWO APPROACHES

Background Discussion surrounds the publication The White Book on Physical and Rehabilitation Methane in Europe as to whether the medical speeralty, termed physical and rehabilitation medicine" is in fact a reality Objective To disclose previously undiscussed issues related to The White Book on physical and Rehabilitation Medium. in Europe by Juxtaposing its content with a body of work from a related healthcare approach termed "self management education" Methods Inspired 11 discourse analysis and actor network theory, texts on both approaches were contrasted Inning vocabularies of their own expressed under certain material conditions Issues Four issues arose (i) the difference in illness tripe tones between a sudden transition from an able to disabled person after a disease with acute onset and the indefinite and unpredictable course of a chronic disease (ii) the different material and social set up of clinical and community rehabilitation settings (iii)the influence of these different implementation environments on goal setting, and (iv) the relative neglect of social theory in physical and rehablitation medicine Conclusion If a bio psycho social functional approach to patients with acute and chronic conditions is regarded as essential for the identity of physical and rehabilitation medicine, the discourse on chronic illness should be paid more explicit attention