Northwestern Health Sciences University, Wolfe-Harris Center for Clinical Studies, Bloomington, MN, USA.
J Rehabil Med. 2014 Nov;46(10):1022-8. doi: 10.2340/16501977-1876.
To explore perceptions of spinal manipulative therapy and exercise among adults aged 65 years and older with chronic neck pain.
Mixed methods study embedded within a randomized clinical trial.
SUBJECTS/PATIENTS: Interviews were conducted with 222 of 241 randomized clinical trial participants. They had a mean age of 72.2 years and they had neck pain of moderate severity and of 6 years mean duration.
Semi-structured interviews were conducted at the completion of the 12 week intervention phase, during which participants received spinal manipulative therapy and exercise interventions. Interviews explored determinants of satisfaction with care, whether or not therapy was worthwhile, and what was liked and disliked about treatment. Interviews were recorded and transcribed; content analysis was used to identify themes within responses.
Participants placed high value on their relationships with health care team members, supervision, individualized care, and the exercises and information provided as treatment. Change in symptoms did not figure as prominently as social and process-related themes. Percpetions of age, activities, and co-morbities influenced some seniors' expectations of treatment results, and comorbidities impacted perceptions of their ability to participate in active care.
Relationship dynamics should be leveraged in clinical encounters to enhance patient satisfaction and perceived value of care.
探讨 65 岁及以上慢性颈痛成年人对脊柱手法治疗和运动的看法。
嵌入随机临床试验的混合方法研究。
受试者/患者：对 241 名随机临床试验参与者中的 222 名进行了访谈。他们的平均年龄为 72.2 岁，颈痛中度，持续 6 年。
在 12 周干预阶段结束时进行半结构化访谈，在此期间，参与者接受了脊柱手法治疗和运动干预。访谈探讨了对护理满意度的决定因素，治疗是否值得，以及对治疗的喜欢和不喜欢的原因。对访谈进行了记录和转录；采用内容分析法对回答中的主题进行了识别。
参与者非常重视与医疗保健团队成员、监督、个性化护理以及作为治疗提供的锻炼和信息的关系。症状的变化并没有像社会和过程相关主题那样突出。年龄、活动和合并症的认知影响了一些老年人对治疗结果的期望，合并症影响了他们参与积极治疗的能力的认知。
应利用临床接触中的关系动态来提高患者满意度和对护理价值的认知。
