Westmoreland Jayne L, Williams Nefyn H, Wilkinson Clare, Wood Fiona, Westmoreland Alex
Plas Menai, Llanfairfechan, Conwy, UK.
Complement Ther Med. 2007 Jun;15(2):121-7. doi: 10.1016/j.ctim.2005.11.006. Epub 2006 Feb 7.
Spinal pain is a common reason for consulting general practitioners (GPs), and complementary therapists such as osteopaths and chiropractors. Patients express greater satisfaction with the care from chiropractors and osteopaths, because they are perceived as having more empathy, diagnostic skill and effective treatment, but their attitude to a GP providing an osteopathy service is unknown.
To explore patients' views of receiving osteopathy in contrast with usual GP care, to provide insight into the psychological benefit of treatment, and to explore their views on how such a service should be provided and funded.
Qualitative study using semi-structured interviews preceded by short questionnaires.
Primary care osteopathy clinic treating patients from Llanfairfechan Health Centre, which also accepted referrals from neighbouring practices in North West Wales in a randomised controlled trial.
Short questionnaires followed by semi-structured interviews with 20 participants. The interview transcripts were analysed by open coding into categories, axial coding to define the categories' properties and selective coding for the final thematic account.
Traditional GP skills were valued, but GP care for spinal pain was perceived as limited and ineffective. Osteopathy was attractive because it did not involve drugs, but it had short-term painful side effects, and some found it frightening. Physical benefits included increased mobility and reduced pain; psychological benefits included removal of fear and improved understanding. Provision of osteopathy by a GP was welcomed, so long as the GP was properly qualified, and had sufficient time.
A GP run osteopathy clinic provided additional physical and psychological benefit. GP consultation might be improved by adopting some features from the osteopathic consultation.
脊柱疼痛是患者咨询全科医生(GP)以及整骨疗法师和脊椎按摩师等辅助治疗师的常见原因。患者对整骨疗法师和脊椎按摩师的治疗更为满意,因为他们被认为更有同理心、诊断能力和有效的治疗方法,但他们对提供整骨疗法服务的全科医生的态度尚不清楚。
探讨患者对接受整骨疗法与常规全科医生治疗的看法,深入了解治疗的心理益处,并探讨他们对这种服务应如何提供和资助的看法。
采用定性研究,在简短问卷之前进行半结构化访谈。
初级保健整骨疗法诊所,治疗来自兰费尔费坎健康中心的患者,该诊所还在一项随机对照试验中接受了威尔士西北部邻近诊所的转诊。
先进行简短问卷,然后对20名参与者进行半结构化访谈。访谈记录通过开放编码分类、轴心编码定义类别属性以及选择编码得出最终主题描述。
传统的全科医生技能受到重视,但全科医生对脊柱疼痛的治疗被认为有限且无效。整骨疗法很有吸引力,因为它不涉及药物,但有短期疼痛的副作用,一些人觉得它令人恐惧。身体上的益处包括活动能力增强和疼痛减轻;心理上的益处包括消除恐惧和增进理解。只要全科医生具备适当资质并有足够时间,患者欢迎其提供整骨疗法服务。
全科医生开办的整骨疗法诊所提供了额外的身体和心理益处。采用整骨疗法咨询的一些特点可能会改善全科医生的诊疗。