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Biomedical subjects

J R Jamison

Publications and source records attributed to J R Jamison.

At least 19 recordsLinked to original sources
PubMed2001

The health information brochure: a useful tool for chiropractic practice?

BACKGROUND: It has been suggested that clinicians should be looking at new ways to enhance their patients' self-care. Patient education is one strategy that primary providers may use. OBJECTIVE: This study investigates the format in which patients would like to pursue their health education within the chiropractic clinic. METHODS: An exploratory study of chiropractic patients was undertaken to investigate patients' preferred health education formats, their commitment to pursuing health objectives, and their literacy level. Purposive sampling of 9 Australian chiropractic clinics was undertaken. Convenience sampling of patients attending these clinics resulted in 102 patients participating. Participants completed a questionnaire. A research assistant was available to clarify any questions. Data were collected and collated. A Likert scale was used to capture responses to questions ascertaining patient opinions. RESULTS: Patients considered health the most important of the life objectives listed; however, they preferred spending time with family to undertaking health- and fitness-promoting activity. More chiropractic patients opted for health information brochures than health promotion classes, personally supervised self-care programs, or practitioner-supervised self-care contracts. Patient literacy levels varied within and between clinics. CONCLUSIONS: Brochures may provide a definitive health information tool for chiropractors who limit their clinical role to primary contact and a helpful adjunct to patient education for chiropractors committed to a primary care role. However, care should be taken to select brochures consistent with the patients' literacy level. Tips for selecting and preparing suitable brochures are provided. The discrepancy between how greatly patients value health and how they prefer spending their time may have implications for successful behavior change. Brochures may not alone constitute adequate practitioner involvement.

Adult↗
PubMed2000

Stress management: an exploratory study of chiropractic patients.

BACKGROUND: Stress is a recognized variable in the diagnosis, management, and prognosis of musculoskeletal conditions; chiropractic care is reputed to be successful in the management of stress-related visceral conditions. It may be useful for chiropractors to include stress management as a clinical care option. OBJECTIVE: To explore screening tools to aid stress self-assessment, investigate patients' perceptions of stress management as a chiropractic care option, and examine which stress-management strategies chiropractic patients perceive as most useful. DESIGN: A multiphase qualitative study with purposive sampling of chiropractic clinics to maximize the diversity of the patient population. Convenience sampling of patients was undertaken in a Western Australian case study, an inner city, and a national exploratory study. Data for the case study were collected by semistructured interview. Questionnaires and a self-assessed stress-management task were used to collect data from the inner city and national studies. Data was thematically analyzed, and results were triangulated. RESULTS: The sample size of chiropractic patients in the West Australian case study was 48, 15 in the Western Australia exploratory study and 36 in the national study. A number of chiropractic patients participating in this study perceive themselves to be stressed and were interested in having stress-management strategies included in their chiropractic care. Individual patients preferred different stress-management options. This qualitative study found little justification for routinely using a stress-assessment technique more complex than asking the patient to rate his or her stress level as absent, minimal, moderate, or severe. Exercise, particularly walking, was found to be a prevalent pasttime among participants in the case study. CONCLUSION: This study was too small to warrant statistical analysis; nonetheless, the results of this study are relevant because some patients believe they would benefit from chiropractic care that includes information about stress-management strategies.

Adolescent↗
PubMed1999

A psychological profile of fibromyalgia patients: a chiropractic case study.

BACKGROUND: Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain and tenderness. Reversible modulation of the pain threshold is believed to contribute to the pathogenesis of this condition, and psychosocial stress is known to alter the pain threshold. OBJECTIVE: To describe and compare the psychological profile of fibromyalgia patients attending chiropractic clinics in Australia. SETTING: Chiropractic clinics located in 5 Australian states and the Australian capital territory with practices in inner city, suburban, coastal, and rural areas were included. SUBJECTS: Chiropractic patients with acute and chronic biomechanical conditions, fibromyalgia, and who were undergoing maintenance care were included in the study. METHOD: A case study to explore the psychological profile of fibromyalgia patients was undertaken. The Distress and Risk Assessment Method (DRAM) and Sense of Coherence (SOC) questionnaires were used to ascertain and compare the distress, sense of coherence, and manageability levels of patients with fibromyalgia with patients having maintenance chiropractic care. Purposive sampling of practitioners and convenience sampling of patients fulfilling the study's inclusion criteria were undertaken. Patients were asked to complete two questionnaires and chiropractors to complete one questionnaire and an interview. RESULTS: While more than half of the patients in the fibromyalgia group were distressed, fewer than 1 in 7 maintenance patients were found to be distressed according to the DRAM questionnaire. With several individual exceptions, fibromyalgia patients also tended to have lower SOC and manageability scores than the maintenance group. CONCLUSION: This study supports the view that fibromyalgia may represent a problem of coping with various environmental stresses, including psychosocial stresses. However, owing to individual variation, a diagnosis of fibromyalgia at the clinical level does not accurately predict whether a particular patient is distressed or has a low SOC score. Screening of fibromyalgia patients may help determine whether intensive counseling and stress management by the chiropractor or another health professional should be contemplated.

Adaptation, Psychological↗
PubMed1998

Informed consent: an Australian case study.

OBJECTIVE: Informed consent, as practiced in Australian chiropractic practice, was explored by means of a collective case study. DESIGN: Twenty-one chiropractic practices were visited and 25 chiropractor-patient units explored. Purposive sampling of practitioners was undertaken using a maximum variation strategy. Convenience sampling of patients was performed within each participating practice. Data was gathered from each chiropractor-patient unit, consisting of one practitioner and usually five patients, by means of practitioner interview, patient questionnaire and interview and, in certain cases, practice observation. Thematic analysis of the interviews were correlated with information derived from the patient questionnaires and validated by selective practice observation. Data was compared within and across chiropractor-patient units. RESULTS: Consent for chiropractic care was usually implied. Chiropractors in this study seldom obtained formal verbal, and never written, informed consent. New chiropractic patients were nonetheless informed about the procedures that the chiropractor intended to perform, and their acquiescence was taken as consent. Participants seldom discussed the potentially serious consequences of chiropractic adjustment but did actively attempt to identify and avoid exposing at-risk patients. Patients were often counseled about potential muscle soreness after the chiropractic adjustment. The behavior of chiropractors in this study was consistent with their patients' expectations. CONCLUSION: This study suggests that chiropractic behavior in Australian clinical practice meets the moral, but not all of the legal, requirements for informed consent.

Adult↗
PubMed1996

Innovations in education: a case study of a novel teaching/learning format.

OBJECTIVE: To describe an innovative teaching/learning option that engages the student as an active learner without compromising the financial advantages of large group/classroom teaching. METHOD: A case study is used to demonstrate an innovative teaching/learning format. The content of the case study is based upon the identification of referral criteria at the patient-health care system interface. The learning experience consists of a quiz followed by class discussion. SAMPLE: A convenience sample of final-year chiropractic and osteopathy students at RMIT. DISCUSSION: The case study demonstrates how this format may be used to create an environment in which each student is personally confronted by the necessity to reach a decision about referring a patient on the basis of the information provided. Having engaged each student in the decision-making process, this format then provides an opportunity for self-assessment and the enunciation of general guidelines during class discussion. An additional demonstrable benefit of this teaching/learning strategy is the lecturer's enhanced awareness of the learning needs of the student group. CONCLUSION: The format proposed provides an additional option for teaching/learning that is acceptable to students and is consistent with the need to contain costs, maintain standards and conform to the requirements of a competency-based curriculum.

Australia↗
PubMed1995

Australian dietary targets in 1995: their feasibility and pertinence to dietary goals for 2000.

To ascertain whether the diet of young students in health-related courses conformed to Australian dietary targets for 1995 and to identify nutritional needs in view of dietary targets for 2000, 246 undergraduate students analysed their weighed diet for three or five days. Eight of ten male participants were meeting the dietary goals for 1995 for fibre and fat intake and six of ten were meeting the goals for 2000. More female participants were meeting the goals for fat, but less than half of the female were meeting the 1995 goals for fibre. Some 84 per cent of females, but only 29 percent of males, were meeting the 1995 dietary goals for sodium. Few participants derived 10 per cent or less of their energy from saturated fat or 10 per cent of their energy from polyunsaturated fatty acids. Substantial numbers of participants failed to meet the recommended daily intakes of zinc. calcium, magnesium and iron (females). Education of specific subgroups and modifications to food production and processing are proposed.

Adult↗
PubMed1995

Medical referral for chiropractic care: a survey of "unconventional" medical practitioners.

OBJECTIVE: To ascertain the attitude toward chiropractic care of Australian medical practitioners who had previously demonstrated a willingness to contemplate a nonconventional mode of clinical intervention. DESIGN: A descriptive study in which eight hundred and twenty (820) medical practitioners were invited to respond to a mailed questionnaire. PARTICIPANTS: Only medical practitioners who had demonstrated an interest in at least one form of nonconventional intervention were surveyed. Seven hundred and ninety-six (796) medical practitioners who subscribe to a professional organization committed to 'alternative' nutritional approaches in health care were mailed a questionnaire. Twenty-four practitioners known to be sympathetic to chiropractic were also included. The response rate was 27%. RESULTS: One quarter of respondents never refer patients to a chiropractor. The major reason given for nonreferral is that physiotherapy is the preferred option. Almost half of the medical practitioners who never refer to chiropractors use manipulation themselves. Half of the medical practitioners who have never referred or have occasionally referred were unsure which of their patients would benefit from chiropractic care. Important referral criteria used by medical practitioners who do undertake chiropractic referral are, in order of importance: prior personal knowledge, the practitioner's professional reputation, qualifications and practice location. These medical practitioners believe that between one and three of every four patients referred received benefit from chiropractic care. CONCLUSIONS: Increased contact between chiropractors and the medical practitioners who were surveyed could lead to a better appreciation of chiropractic's potential contribution in health care.

Attitude of Health Personnel↗
PubMed1995

Chiropractic referral: the views of a group of conventional medical practitioners with an interest in unconventional therapies.

OBJECTIVE: To identify, from a list of conditions prepared by leaders in the Australian chiropractic profession, disorders that medical practitioners regard as suitable for referral for chiropractic care. DESIGN: A descriptive study in which eight hundred and twenty (820) medical practitioners with an interest in "unconventional" interventions were invited to respond to a mailed questionnaire. PARTICIPANTS: Medical practitioners with a demonstrable interest in at least one form of nonconventional therapy were surveyed. Seven hundred and ninety-six medical practitioners who subscribe to a professional organization committed to "alternative" nutritional approaches in health care were sent mail. Twenty-four practitioners known to be sympathetic to chiropractic were also included. The response rate was 28%. RESULTS: Medical respondents who refer to chiropractors more frequently consider a larger number of conditions suitable for chiropractic care than those who never refer. Referral of patients with visceral disorders enjoys relatively little support, especially among practitioners who never actually use chiropractic referral as an intervention option. Analysis of perceptions regarding chiropractic referral of patients with headaches suggests that the perceived etiology of the symptom is a consideration in making referral decisions. CONCLUSION: Chiropractic referral for musculoskeletal care enjoys substantial support, whereas referral for chiropractic intervention in visceral conditions continues to be largely opposed by those members of the medical profession participating in this study.

Attitude of Health Personnel↗
PubMed1991

Evaluating primary practice: proposals for a modified model suited to chiropractic care.

Although chiropractic care is not yet considered to have achieved scientific validity, it enjoys widespread public acceptance. It is hypothesised that one of the barriers to chiropractic establishing scientific validity is the propensity of researchers to frame their randomized controlled clinical trials according to a biomedical rather than a biopsychosocial model. It is proposed that while chiropractic care should be required to establish a cause--effect relationship between spinal manipulation and clinical response, subjective patient--valued outcomes should also be monitored. For chiropractic care to be adequately assessed recognition needs to be given to the usefulness of qualitative measurements in health care. Interventions selected solely upon the basis of statistical significance run the risk of overlooking clinically meaningful outcomes.

Chiropractic↗
PubMed1991

Science in chiropractic clinical practice: identifying a need.

The chiropractic profession has resolved to establish chiropractic clinical care upon a scientifically acceptable foundation. In order for such an ambition to be realized, the cooperation and participation of field practitioners is required. A survey of chiropractors practicing in Australia demonstrated that respondents largely failed to appreciate the power of various research designs to provide clinical practice information. This paper suggests the chasm between professional resolve and clinical practice is not being adequately bridged at the level of field practitioners.

Attitude of Health Personnel↗
PubMed1991

Drugs in chiropractic clinical practice: contemplating the variables which influence utility.

Philosophical commitment to a natural form of health care does not exempt practitioners who function in a drug-utilizing health care system from an appreciation of the potential use and abuse of pharmaceutical agents. The strategies used for evaluating drug therapy may provide a framework for ascertaining the clinical appropriateness of drugless forms of health care. This paper proposes that in view of the regular use of drugs by chiropractic patients, the prescription of nutritional supplements by chiropractors and the universal applicability of the management principles underlying the "drug model," chiropractic practitioners would benefit from familiarity with the theory and practice underlying the use of certain drugs.

Anti-Inflammatory Agents, Non-Steroidal↗
PubMed1990

Dietary intervention in the clinical prevention of ischemic heart disease.

While some scientific doubt lingers with regard to the validity of minimizing mortality rates attributable to ischemic heart disease via nutritional strategies targeted at coronary risk factors, popular consensus is committed to such intervention. Chiropractic respondents largely support the notion that nutritional intervention can indeed facilitate prevention of ischemic heart disease. The precise strategies whereby such disease prevention may be achieved have proven problematic; even respondents who conceptually supported particular intervention strategies demonstrated some hesitation in clinically implementing their beliefs.

Australia↗
PubMed1990

Counteracting nutritional misinformation: a curricular proposal.

Health authorities are concerned about community exposure to nutritional misinformation. Adequate education of health professionals in nutritional matters has been proposed as an important strategy for counteracting such misinformation. This paper provides an example of how the undergraduate chiropractic curriculum may be used to facilitate the development of a framework which enables discrimination between nutritional sense and nonsense. It also discusses how student awareness of discrepancies between personal belief, nutritional science and clinical practice reality may be enhanced.

Ascorbic Acid↗