Lee Mi Kyung, Amorin-Woods Lyndon, Cascioli Vincenzo, Adams Jon
1School of Health Professions, Murdoch University, Perth, Australia.
2Faculty of Health, University of Technology Sydney, Sydney, Australia.
Chiropr Man Therap. 2018 Feb 20;26:7. doi: 10.1186/s12998-018-0175-1. eCollection 2018.
Food consumption and nutritional status affect an individual's health throughout their life-course and an unhealthy diet is a major risk factor for the current global burden of chronic disease. The promotion of health and good nutrition through healthy eating requires the active involvement of all health professionals including chiropractors. This paper reports findings from the first nationally representative examination of the use of nutritional guidance within chiropractic patient management in Australia.
A sample of 1000 practising chiropractors was randomly selected from the Australian Chiropractic Research Network (ACORN) practice-based research network database for a cross-sectional study and 33% participated in the online survey in November 2016. The questionnaire, based on previous designs used in similar surveys and nutrition resources developed by the National Health and Medical Research Council, was pretested prior to the survey. Pearson's Chi square and bivariate logistic regression were undertaken to explore relationships with variables of interest.
The demographic details of the respondents are similar to those of the chiropractic workforce registered in Australia. Most chiropractors provided nutritional advice as part of their patient care and around a quarter provided specific dietary advice to their patients, including the use of nutrition supplements. Nutrition-related conditions most commonly encountered by the chiropractors were musculoskeletal, usually inflammatory in origin. Common nutritional assessment methods used included questioning patients to assess their nutritional and health status and physical appearance. Most of the participants provided nutritional resources to their patients in their clinics. However, the Australian Dietary Guidelines and the accompanying Australian Guide to Healthy Eating were not well utilised by the respondents. Australian chiropractors often referred patients with nutrition issues to qualified dietitians and other health professionals when deemed necessary.
Australian chiropractors regularly provide nutritional advice and appear to acknowledge the importance of nutrition in their clinical practice especially for patients presenting with chronic disease. If chiropractors are to fulfil their potential in providing such wider public health and preventative health advice to patients, further research examining the utilisation of evidence-based nutrition resources within chiropractic patient management is recommended.
食物摄入和营养状况会在个体的整个生命历程中影响其健康，不健康的饮食是当前全球慢性病负担的主要风险因素。通过健康饮食促进健康和良好营养需要包括脊椎按摩师在内的所有健康专业人员的积极参与。本文报告了澳大利亚首次对脊椎按摩治疗患者管理中营养指导使用情况进行的全国代表性调查结果。
从澳大利亚脊椎按摩研究网络（ACORN）基于实践的研究网络数据库中随机抽取1000名执业脊椎按摩师作为样本进行横断面研究，2016年11月33%的人参与了在线调查。该问卷基于之前类似调查中使用的设计以及澳大利亚国家卫生与医学研究委员会开发的营养资源，在调查前进行了预测试。采用Pearson卡方检验和二元逻辑回归来探讨与感兴趣变量的关系。
受访者的人口统计学细节与在澳大利亚注册的脊椎按摩治疗人员相似。大多数脊椎按摩师在患者护理中提供营养建议，约四分之一的人向患者提供特定的饮食建议，包括使用营养补充剂。脊椎按摩师最常遇到的与营养相关的病症是肌肉骨骼方面的，通常起源于炎症。常用的营养评估方法包括询问患者以评估其营养和健康状况以及身体外观。大多数参与者在其诊所为患者提供营养资源。然而，受访者对《澳大利亚饮食指南》及其附带的《澳大利亚健康饮食指南》的利用率不高。澳大利亚的脊椎按摩师在必要时经常将有营养问题的患者转介给合格的营养师和其他健康专业人员。
澳大利亚的脊椎按摩师经常提供营养建议，并且似乎认识到营养在其临床实践中的重要性，特别是对于患有慢性病的患者。如果脊椎按摩师要充分发挥其潜力，为患者提供更广泛的公共卫生和预防性健康建议，建议进一步研究脊椎按摩治疗患者管理中循证营养资源的利用情况。
