Biomedical subjects

C Hawk

Publications and source records attributed to C Hawk.

23 records · Page 2Linked to original sources

PubMedDate not supplied

Prevalence of nonmusculoskeletal complaints in chiropractic practice: report from a practice-based research program.

OBJECTIVE: To identify patient and practice characteristics that might contribute to people's seeking chiropractic care for nonmusculoskeletal complaints. DESIGN: This was a cross-sectional study conducted through the methods of practice-based research. SETTING: Data were collected in 1998--1999 in chiropractic offices in the United States, Canada, and Australia; data were managed by a practice-based research office operating in a chiropractic research center. POPULATION: The subjects were new and established patients of all ages who visited the participating offices during a designated data collection week. DATA ANALYSIS: Multiple logistic regression was used to examine factors associated with patients' presenting for nonmusculoskeletal chief complaints. Pearson's chi(2) test was used to examine associations among practice variables and the proportion of patients with nonmusculoskeletal chief complaints. RESULTS: A total of 7651 patients of 161 chiropractors in 110 practices in 32 states and 2 Canadian provinces participated; data from 2 Australian practices were included in the totals but not in the analysis. Nonmusculoskeletal complaints accounted for 10.3% of the chief complaints. The following characteristics made patients more likely to present with nonmusculoskeletal chief complaints: being less than 14 years of age (adjusted odds ratio [AOR], 6.9; 95% CI, 5.2--9.1); being female (AOR, 1.5; CI, 1.3--1.8); presenting in a small town/rural location (AOR, 1.9; CI, 1.3--2.7); reporting more than 1 complaint, especially nonmusculoskeletal complaints (AOR, 4.9; CI, 3.9--6.0); having received medical care for the chief complaint (AOR, 3.4; CI, 2.9--4.1); and having first received chiropractic care before 1960 (AOR, 1.7; CI, 1.1--2.4). Practices with the highest proportion of patients with nonmusculoskeletal chief complaints (>17%) were less likely to accept insurance and more likely to be in locations with populations greater than 100,000. They used the most common chiropractic adjustive techniques less frequently and used more nonadjustive procedures, especially diet/nutrition counseling, nutritional supplementation, herbal preparations, naturopathy, and homeopathy. CONCLUSIONS: Drawing on practices with the patient and practice characteristics identified in this study to conduct outcomes studies on nonmusculoskeletal conditions is a possible direction for future research.

Adolescent↗

PubMedDate not supplied

Chiropractors' attitudes toward training in prevention: results of a survey of 492 U.S. chiropractors.

OBJECTIVE: To assist in assessing practicing DCs' attitudes toward and expressed needs for prevention-related training, particularly those topics most relevant to a primary care practice. DESIGN: Data were obtained from a mail survey of a random sample of 753 U.S. chiropractors. Data analysis included stratification and multiple logistic regression to examine the effects of gender, years of practice and chiropractic college attended on training, reported in 23 prevention topics. Responses were compared with those from a similar published survey of MDs. SETTING: The sampling frame was stratified into eight geographic regions with approximately equal numbers of DCs. PARTICIPANTS: The sampling frame consisted of chiropractors listed in the 1993-4 edition of the National Directory of Chiropractic. RESULTS: The survey response rate was 65.3%. Although 90.4% of respondents consider themselves primary care practitioners, a significantly fewer (p = .00) 78.5% reported adequate training as such in chiropractic college. Fewer women than men reported adequate training. Respondents with fewer years in practice reported more training in chiropractic college for fourteen of twenty-three prevention topics than respondents with more years in practice. Differences in reported training were detected among graduates of different chiropractic colleges in two topics: cancer detection and immunization, con aspect. Comparing this survey to that of MDs, more primary care MDs than DCs reported training in every topic. When training in addition to that in chiropractic college was reported, DCs reported training that more closely approximated primary care MDs. CONCLUSIONS: The self-reported information in this survey may provide some insight into respondents' perception of their education in prevention and their need for additional training. These findings indicate that although prevention training seems to be increasing in the chiropractic colleges, an apparent need exists for further emphasis on preventive care, particularly in areas most relevant to a primary care practice.

Attitude of Health Personnel↗

PubMedDate not supplied

The National Workshop to Develop the Chiropractic Research Agenda.

OBJECTIVE: To convene a national meeting to develop a research agenda for the chiropractic profession that targets the need to increase chiropractic's research capacity. DESIGN: The project was funded by a contract between the U.S. Health Resources and Services Administration Bureau of Health Professions (HRSA BHPr) and Palmer College of Chiropractic. Groundwork was established through a literature review and creation of position papers by teams of recognized authorities on the current status and recommendations for the future on the topics of clinical, educational, outcomes, basic science, and health services research and research infrastructure in chiropractic. The workshop took place July 12-14, 1996, in Washington, DC, with participants representing relevant segments of the research community of the health care professions, health professions education, health care policy, and all portions of the chiropractic community, including researchers, practitioners, faculty, administrators, and members of professional organizations. Work groups in each of the five target areas developed recommendations based on the seed material presented in the position papers. The results were incorporated into the final position papers. RESULTS: The primary outcome of the workshop was the completion of five position papers, one for each of the topics addressed. Also, a consensus process was initiated at the workshop on infrastructure needs of the profession but, because of the diversity of experience and opinions and the broad scope of the topic, was not completed by the end of the project year. CONCLUSIONS: Consensus was not reached on the development of a research agenda for the chiropractic profession, and a continuation of the contract has been agreed upon by HRSA BHPr to continue the process for another project year.

Chiropractic↗

PubMedDate not supplied

Development of a practice-based research program.

OBJECTIVE: To establish an infrastructure to collect accurate data from ambulatory settings. DESIGN: The program was developed through an iterative model governed by a process of formative evaluation. The three iterations were a needs assessment, feasibility study and pilot project. Necessary program components were identified as infrastructure, practitioner-researcher partnership, centralized data management and standardized quality assurance measures. SETTING AND PARTICIPANTS: Volunteer chiropractors and their staff collected data on patients in their practices in ambulatory settings in the U.S. and Canada. OUTCOME MEASURES: Evaluative measures were counts of participants, patients and completed forms. Standardized, validated and reliable measures collected by patient self-report were used to assess treatment outcomes. These included the SF-36 or SF-12 Health Survey, the Pain Disability Index, and the Global Well-Being Scale. For characteristics for which appropriate standardized instruments were not available, questionnaires were designed and and pilot-tested before use. RESULTS: Information was gathered on practice and patient characteristics and treatment outcomes, but for this report, only those data concerning process evaluation are reported. Through the three program iterations, 65 DCs collected data on 1360 patients, 663 of whom were new patients. Follow-up data recorded by doctors were obtained for more than 70% of patients; a maximum of 50% of patient-completed follow-up forms were collected in the three iterations. CONCLUSIONS: This program is capable of providing data for descriptive epidemiology of ambulatory patients, and, with continued effort to maximize follow-up, may have utility in providing insight into utilization patterns and patient outcomes.

Algorithms↗

PubMedDate not supplied

Chiropractic radiologists: a survey of demographics, abilities, educational attitudes and practice trends.

OBJECTIVE: To assess the education, abilities, practices and opinions of chiropractic radiologists. DESIGN: Eight-page survey with two mailings. PARTICIPANTS: One hundred seventy-five diplomates of the American Chiropractic Board of Radiology listed with the American Chiropractic College of Radiology office. RESULTS: Of the surveys mailed, 111 of the 175 were returned from the individuals listed with the American Chiropractic College of Radiology office. After excluding the deceased and those with a self-reported retired status, the response rate was calculated as 66%. Of those who responded, 81% were male; the mean age was 46.4 +/- 11.2 yr (mean +/- standard deviation). Most respondents were residents of California, followed by Canada and Illinois. Thirty-six percent taught at chiropractic colleges. They felt most confident in interpreting plain film studies of the musculoskeletal system. Many have undergone advanced training in specialized imaging. They felt topics related to patient positioning, plain film physics, arthritides, trauma, avascular necrosis and tumors are most important to a chiropractic curriculum. Most respondents felt the use of plain film radiology was most appropriate when the clinical presentation of the patient suggests the strong possibility of underlying disease. CONCLUSIONS: Radiology is an important topic to the education of students and the practice of chiropractic. The results of this survey will assist future decision-making regarding student education and clinical use of radiology.

Adult↗