CJA Vol.31 Issue 3Editorial: We Have Met the Enemy, and They Are Us Spinal Stenosis: Case Report with a Review of the
Literature Chiropractic Patient-Centred Care: Suggestions from
an International Case Study Commentary: The Nature of the Principles of Chiropractic Australian Spinal Research Foundation: Glimpses of the First 25
Years ABSTRACTS Spinal Stenosis: Case Report with a Review of the Literature FRANK O. PEDERICK This paper discusses the care of a patient with spinal stenosis and reviews some of the neurophysiological research from the past in an attempt to suggest ways in which full-spine adjusting of such patients may result in quantifiable improvement. That chiropractic care is of value in chronic conditions such as spinal stenosis is documented in the literature (e.g. Kirkaldy Willis and Cassidy), but not the extent required by the gatekeepers of the Cochrane Collaboration Back Group. For chiropractors considering referral of patients with spinal stenosis to medical practitioners, a review of current literature is included which shows there is a range of opinion on diagnosis and treatment. Patients initially need conservative forms of care and should be carefully selected for surgery, which will give a satisfactory result for about two out of three patients; nearly one in five will undergo further surgery. Trial research involving chiropractors in the assessment and treatment of those diagnosed with spinal stenosis is recommended on the basis of potential improvements in patient outcomes and reduced expenditure. INDEX TERMS: (MESH) CHIROPRACTIC; MANIPULATION, ORTHOPEDIC; SPINAL STENOSIS; SPONDYLOLISTHESIS; MECHANORECEPTORS; NEUROPATHOPHYSIOLOGY; NOCICEPTORS. (0THER) ALLODYNIA; COCHRANE COLLABORATION; SENSITIZATION. Chiropr J Aust 2001;31:82-91. Chiropractic Patient-Centred Care: Suggestions from an International Case Study JENNIFER R. JAMISON Patient-centred care, a notion consistent with chiropractic’s philosophical constructs, is emerging as a dominant health care paradigm in the 21st century. This international case study sought to identify the health information needs and interests of chiropractic patients with a view to clarifying some variables deserving consideration when defining an appropriate chiropractic patient-centred practice model. Method: An exploratory study of five chiropractic practices, one in South Africa, two in the Republic of Ireland, and two in the U.S.A., was undertaken. Convenience sampling resulted in participation by 50 South African, 75 Irish and 30 American patients. Participants were asked to select from a list of health information topics, to report on their lifestyle choices with respect to smoking, alcohol, exercise and certain dietary habits and to note their “top of the mind” responses to the word triggers “health information” and “chiropractic/chiropractor.” Results were compared with a similar Australian study. Results: While each individual has unique interests and expectations, a number of chiropractic patients favour general health information also being available in their chiropractic clinics. Many of the behavioural choices of chiropractic patients are consistent with health promotion, nonetheless there are those who would benefit from personalised health information. Patients more readily perceive chiropractors as spinal experts than as a health information source. Conclusions: As the chiropractic profession strives to establish itself as an influential health partner offering patient-centred care, it is suggested that the character of chiropractic patient-centred care not be limited to spinal adjustments and exercise, but, based on the health information interests of chiropractic patients, be expanded to incorporate a more comprehensive definition of wellness. INDEX TERMS: PATIENT-CENTRED CARE; PHILOSOPHY; HEALTH INFORMATIN Chiropr J Aust 2001;31:92-7. |
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