Innes Stanley I, Leboeuf-Yde Charlotte, Walker Bruce F
School of Health Professions, Murdoch University, Murdoch, Australia.
Institut Franco-Européen de Chiropraxie, Ivry sur Seine, Paris, France.
Chiropr Man Therap. 2017 Jul 19;25:20. doi: 10.1186/s12998-017-0150-2. eCollection 2017.
Psychological factors, such as intolerance of uncertainty (IU), have been shown to impact on the quality of medical care. However, this psychological measure has not been studied in the chiropractic profession. Our objective was to investigate if higher levels of IU in chiropractic students were related to poor choices of management in specific clinical scenarios. Also, we sought to investigate if levels of IU were related to students' intentions to adopt a prescriptive chiropractic technique system and evaluate their levels of self-belief.
Between October and November of 2016, students from two Australian chiropractic programs ( = 444) answered a questionnaire on measures of IU levels, patient case scenarios for neck and low back pain, and questions about self-ratings of their future chiropractic abilities and perceived need for the adoption of a chiropractic technique system. Associations were tested by the IU score and the therapeutic choices relating to a) a neck pain case scenario, b) a low back pain scenario, c) various technique systems, and d) the self-rated competence level treating the IU score both as a continuous and a categorical variable.
There was an overall response rate of 53%. Those students who were high in levels of IU were significantly more likely to make incorrect clinical decisions than those with normal or low levels of IU for the neck pain case scenario. No differences were found on the low back pain scenario, on preferences to use a technique system in the future, or on predicted self-rating of competence after graduation.
Psychological factors, such as IU, may have an impact on chiropractic students' clinical decisions. However, it does not impact on all aspects of practice. This finding has implications for chiropractic educators, especially when dealing with neck pain. However, it may be relevant to continue the search for specific personality profiles in relation to various favourable and unfavourable practice patterns, as it is unknown whether these dynamics are important for other aspects of chiropractic education.
心理因素，如对不确定性的不耐受（IU），已被证明会影响医疗质量。然而，这种心理测量方法尚未在整脊专业中进行研究。我们的目的是调查整脊专业学生中较高水平的IU是否与特定临床场景中管理选择不当有关。此外，我们试图调查IU水平是否与学生采用规范性整脊技术系统的意图有关，并评估他们的自我信念水平。
2016年10月至11月期间，来自两个澳大利亚整脊项目的学生（n = 444）回答了一份关于IU水平测量、颈部和下背部疼痛患者病例场景的问卷，以及关于他们未来整脊能力的自我评分和采用整脊技术系统的感知需求的问题。通过IU评分以及与以下方面相关的治疗选择来测试关联性：a）颈部疼痛病例场景，b）下背部疼痛场景，c）各种技术系统，以及d）将IU评分作为连续变量和分类变量时治疗IU评分的自我评定能力水平。
总体回复率为53%。在颈部疼痛病例场景中，IU水平高的学生比IU水平正常或低的学生更有可能做出错误的临床决策。在下背部疼痛场景、未来使用技术系统的偏好或毕业后能力的预测自我评分方面未发现差异。
心理因素，如IU，可能会影响整脊专业学生的临床决策。然而，它并不影响实践的所有方面。这一发现对整脊教育工作者具有启示意义，尤其是在处理颈部疼痛时。然而，由于尚不清楚这些动态因素对整脊教育的其他方面是否重要，因此可能有必要继续寻找与各种有利和不利实践模式相关的特定人格特征。
