{"title":"L’interdisciplinarité pour des soins holistiques en hôpital psychiatrique : pourquoi et comment relever ce défi ?","authors":"Patricia Kirkove , Pierre Oswald","doi":"10.1016/j.amp.2023.09.013","DOIUrl":null,"url":null,"abstract":"<div><p>There is considerable confusion between the terms multidisciplinarity, interdisciplinarity and transdisciplinarity. Multidisciplinarity suggests a juxtaposition of knowledge. The various specialists in their disciplines complement each other and intervene alongside each other around a common subject. This produces points of view, which are superimposed, without bringing out any real added value. Interdisciplinarity requires interaction and interrelation. The pooling of knowledge requires a greater intertwining of disciplines, minimizing the differences between them while preserving their specificities and their foundations. A specialist's robust monodisciplinary expertise enriches the other members of the team, allowing for a more global, more systemic approach. Refusing to approach complex problems through the categorial prism of individual disciplines, transdisciplinarity seeks to integrate disciplines to go between, through and beyond disciplines by completely dissolving traditional boundaries. One of the particularities of complex holistic care, such as that in psychiatry, is that it cannot be managed effectively by a single person or a single discipline. Hyperspecialization results in a segmentation of the human being by no longer taking into account the entirety of the person treated. By analyzing and harmonizing the links between the different disciplines, interdisciplinarity sheds light on complex situations and enriches the responses offered. It improves quality, offers a global approach to the patient by mobilizing knowledge from different disciplines and by defragmenting and decompartmentalizing their knowledge. Interdisciplinarity is not self-evident and it cannot be likened to a simple mode of coordination where complementarity is valued. To meet this challenge, communication, coordination and clarification of roles by the team leader, whose leadership is recognized and valued, are essential. The medical literature recognizes a real added value of interdisciplinary approaches in complex medical situations. Eventually, it may be necessary to go a step further. Nevertheless, transdisciplinarity is of such complexity and requires such maturity of the teams, that we do not support it as the first step toward implementing a patient holistic approach. By way of conclusion, we propose the metaphors that Choi and Pak developed. Multidisciplinarity is in a way a mathematical equation of the “2<!--> <!-->+<!--> <!-->2<!--> <!-->=<!--> <!-->4” type or, more daringly, a “salad bowl”, juxtaposition and addition of ingredients or skills. Interdisciplinarity is likened to an equation of the “2<!--> <!-->+<!--> <!-->2<!--> <!-->=<!--> <!-->5” type or a “melting pot”, which postulates that the result, due to an effective and harmonious interaction, is greater than the sum of the parts. Finally, they compare transdisciplinarity using a “2<!--> <!-->+<!--> <!-->2<!--> <!-->=<!--> <!-->yellow” equation with the culinary metaphor of the “cake” highlighting integration.</p></div>","PeriodicalId":7992,"journal":{"name":"Annales medico-psychologiques","volume":null,"pages":null},"PeriodicalIF":0.5000,"publicationDate":"2024-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Annales medico-psychologiques","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0003448723003128","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"PSYCHIATRY","Score":null,"Total":0}
引用次数: 0
Abstract
There is considerable confusion between the terms multidisciplinarity, interdisciplinarity and transdisciplinarity. Multidisciplinarity suggests a juxtaposition of knowledge. The various specialists in their disciplines complement each other and intervene alongside each other around a common subject. This produces points of view, which are superimposed, without bringing out any real added value. Interdisciplinarity requires interaction and interrelation. The pooling of knowledge requires a greater intertwining of disciplines, minimizing the differences between them while preserving their specificities and their foundations. A specialist's robust monodisciplinary expertise enriches the other members of the team, allowing for a more global, more systemic approach. Refusing to approach complex problems through the categorial prism of individual disciplines, transdisciplinarity seeks to integrate disciplines to go between, through and beyond disciplines by completely dissolving traditional boundaries. One of the particularities of complex holistic care, such as that in psychiatry, is that it cannot be managed effectively by a single person or a single discipline. Hyperspecialization results in a segmentation of the human being by no longer taking into account the entirety of the person treated. By analyzing and harmonizing the links between the different disciplines, interdisciplinarity sheds light on complex situations and enriches the responses offered. It improves quality, offers a global approach to the patient by mobilizing knowledge from different disciplines and by defragmenting and decompartmentalizing their knowledge. Interdisciplinarity is not self-evident and it cannot be likened to a simple mode of coordination where complementarity is valued. To meet this challenge, communication, coordination and clarification of roles by the team leader, whose leadership is recognized and valued, are essential. The medical literature recognizes a real added value of interdisciplinary approaches in complex medical situations. Eventually, it may be necessary to go a step further. Nevertheless, transdisciplinarity is of such complexity and requires such maturity of the teams, that we do not support it as the first step toward implementing a patient holistic approach. By way of conclusion, we propose the metaphors that Choi and Pak developed. Multidisciplinarity is in a way a mathematical equation of the “2 + 2 = 4” type or, more daringly, a “salad bowl”, juxtaposition and addition of ingredients or skills. Interdisciplinarity is likened to an equation of the “2 + 2 = 5” type or a “melting pot”, which postulates that the result, due to an effective and harmonious interaction, is greater than the sum of the parts. Finally, they compare transdisciplinarity using a “2 + 2 = yellow” equation with the culinary metaphor of the “cake” highlighting integration.
期刊介绍:
The Annales Médico-Psychologiques is a peer-reviewed medical journal covering the field of psychiatry. Articles are published in French or in English. The journal was established in 1843 and is published by Elsevier on behalf of the Société Médico-Psychologique.
The journal publishes 10 times a year original articles covering biological, genetic, psychological, forensic and cultural issues relevant to the diagnosis and treatment of mental illness, as well as peer reviewed articles that have been presented and discussed during meetings of the Société Médico-Psychologique.To report on the major currents of thought of contemporary psychiatry, and to publish clinical and biological research of international standard, these are the aims of the Annales Médico-Psychologiques.