Theo van Rijn1. 1. Division of Physical Medicine and Rehabilitation, Department of Medicine, University of British Columbia, Vancouver, British Columbia, Canada. tvanrijn@interchange.ubc.ca
Abstract
OBJECTIVE: This article will discuss the influence of response shift on clinical care of patients and the impact it has on care decisions from the perspective of a physiatrist. STUDY DESIGN AND SETTING: The case series presented in this article is from a compilation of clinical observations made over the course of 25 years as a physician specializing in Physical Medicine and Rehabilitation. RESULTS: Four clinical vignettes describe how changes in health status can affect different persons and their treating clinicians. Each scenario reflects how different biopsychosocial circumstances can influence a response shift because of changes in internal standards, values, and/or conceptualization. CONCLUSION: As a concept based on health-related research, response shift still remains somewhat a clinical enigma. The clinical vignettes used in this article outline the complexity of clinically understanding the nature of response shift.
OBJECTIVE: This article will discuss the influence of response shift on clinical care of patients and the impact it has on care decisions from the perspective of a physiatrist. STUDY DESIGN AND SETTING: The case series presented in this article is from a compilation of clinical observations made over the course of 25 years as a physician specializing in Physical Medicine and Rehabilitation. RESULTS: Four clinical vignettes describe how changes in health status can affect different persons and their treating clinicians. Each scenario reflects how different biopsychosocial circumstances can influence a response shift because of changes in internal standards, values, and/or conceptualization. CONCLUSION: As a concept based on health-related research, response shift still remains somewhat a clinical enigma. The clinical vignettes used in this article outline the complexity of clinically understanding the nature of response shift.
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