文摘
Background: Chiropractic, which is recognized for its success in the management of back pain, relies on manual intervention for clinical care. However, psychoemotional factors are known to influence the presentation and clinical outcome of patients with back pain. Objective: This study describes the psychologic profile of chiropractic patients and argues for broadening chiropractic's case management. Method: Eight chiropractors were requested to recruit patients, taking care to include workers' compensation cases. Patients were requested to complete as many as 3 questionnaires. Patients completed the first questionnaire on admission and the second 3 weeks later or on discharge, whichever occurred first. Patients still receiving care at 3 months completed a third questionnaire. Validated questionnaires were used to assess psychologic status. Practitioners were asked to document the patient's level of disability. Results: A total of 116 patients entered the study; 57 % had acute symptoms on admission, and 53 % of all recruited patients were injured at work. Analysis with the Dallas Pain Questionnaire suggested that only 2 acute patients with non-work care injurieswould respond well to medical intervention alone; all other patients also required behavioral intervention. Of the 105 patients who completed the Distress and Risk Assessment Method questionnaire, 36 % were found to be normal, 34 % were found to be at risk, and 30 % were found to be distressed. Of the 108 patients in this study who completed the Bedford Foulds Personal Disturbance scale analysis, 31 % were personally disturbed, and 40 % were psychologically ill. Conclusion: The extent of psychologic disease among chiropractic patients with acute and chronic work care and non-work care injuries suggests it may be prudent for chiropractors to consider expanding their clinical focus to include psychoemotional status. (J Manipulative Physiol Ther 2002;25:e4)
