Biomedical subjects

J M Langworthy

Publications and source records attributed to J M Langworthy.

3 recordsLinked to original sources

PubMed2000

Chiropractic through the eyes of physiotherapists, manual therapists, and osteopaths in The Netherlands.

OBJECTIVES: To identify current perceptions and levels of awareness of chiropractic among physiotherapists, osteopaths, and manual therapists in The Netherlands. In addition, to investigate how future communication and interprofessional collaboration between the four professions may be improved in the interests of patient care as perceived by these groups. DESIGN: Four hundred and ninety-four (494) questionnaires were distributed to 100 manual therapists, 299 physiotherapists, and 95 osteopaths across The Netherlands. Questionnaires were identical for each profession. RESULTS: An overall response rate of 48% was achieved. The majority of practitioners reported limited knowledge of chiropractic. However, chiropractic was generally perceived as a primary health care profession most suited to extramural care. Sixty-seven percent (67%) of the manual therapists regarded it as direct competition, while 45% of the osteopaths and 48% of physiotherapists considered chiropractic complementary to their professions. While the majority of osteopaths felt that statutory self-regulation should be granted to chiropractors in The Netherlands, this was not supported by the manual therapists and physiotherapists. Moreover, there was only minimal (4%-11%) support for the availability of chiropractic treatment as part of the Dutch National Health Service. Although most respondents had never had contact with a local chiropractor, all osteopaths and 50% of the manual therapists and physiotherapists considered chiropractors to be skilled practitioners. However, this was more likely to be so if they had had contact with a chiropractor in the past. Current levels of communication and cooperation were thought to be poor to nonexistent although the majority welcomed closer links, particularly in relation to the treatment of spinal complaints. CONCLUSION: Greater awareness appears to be associated with increased levels of interprofessional acceptance and respect. The professions may wish to pursue areas of broad agreement identified by their practitioners in the interests of professional development and optimal standards of care for individuals in need of musculoskeletal services.

Adult↗

PubMed1997

Rationalizing back pain: the development of a classification system through cluster analysis.

OBJECTIVE: The clinical variations in undifferentiated back pain pose problems for those attempting to develop strategies for care. The objective of this work was to test a methodology for the experimental generation of clinical subgroups of patients with such a complaint, so as to assist more structured study of its natural history and response to treatment. DESIGN: Cluster analysis of dichotomous symptomatic variables from computer-based case histories of three patient cohorts. SETTING: Chiropractic and Orthopedic outpatient clinics. PATIENTS: Three cohorts of new patients with back pain whose symptoms were recorded in a highly standardized way using an interactive computer interview system. CRITERIA ASSESSED: Twenty-four aggravating, relieving and cyclic features of the patients' back complaints assessed for degrees of association and formation of reproducible clusters. RESULTS: Two main patient categories were discerned: one with mechanical features and one that was cyclic. Most patients were assignable to a group. Groupings were largely consistent across all three cohorts and were not related to patient demographics. CONCLUSION: Reproducible and easily-recognized clinical subgroups of back pain patients are possible by cluster analysis using dichotomous case-history variables. More definitive categorization should be obtainable by refining the variable selection and repeating the analysis for additional patient cohorts. These subgroups have the potential to increase the relevance of natural history studies and clinical trials to the day-to-day management of the problem.

Ambulatory Care Facilities↗

PubMedDate not supplied

General practice and chiropractic in Norway: how well do they communicate and what do GPs want to know?

BACKGROUND: Some within the medical establishment believe that the education and training of chiropractors is grounded in orthodox medicine and that these professional groups share a common language allowing for close dialogue. However, levels of communication and collaboration often remain low. Furthermore, studies have shown chiropractors to be lax in providing written reports to referring clinicians, a practice important to both patient care and interprofessional relationships. OBJECTIVE: To investigate existing levels of communication between general practitioners (GPs) and chiropractors in Norway and to identify trends in GP preferences for future interprofessional communications. DESIGN AND SETTING: A postal survey was conducted on a random sample of 230 GPs in Norway. RESULTS: A response rate of 51% was achieved. All respondents reported having made at least one referral to a chiropractor. Most (63%) referred infrequently, and only 7% communicated often with a chiropractor. Of those who were in contact with a chiropractor, three fourths communicated by telephone. One fifth of the respondents negatively assessed the quality of written reports. Approximately one third of those GPs who had referred patients did not receive a report, despite this being obligatory in Norway. Twelve percent reported problems with terminology. A written report for future reporting was favored by 75% of the GPs, who wanted the report to contain information on examination findings, diagnosis, treatment, and advice given. CONCLUSION: In general, communications between GPs and chiropractors in Norway are not ideal, particularly with regard to frequency and written quality. However, this is not unique to Norway. With increasing emphasis on multidisciplinary health care, greater understanding and better communication is needed to optimize the benefits of such an approach to patient management. Relevant, timely, consistent reporting on a reciprocal basis, together with a shared vocabulary, should help this process.

Adult↗