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澳大利亚城乡及偏远地区脊椎按摩师的患病率及执业特点:对1830名脊椎按摩师的全国代表性样本的分析。

Prevalence and practice characteristics of urban and rural or remote Australian chiropractors: Analysis of a nationally representative sample of 1830 chiropractors.

作者信息

Adams Jon, de Luca Katie, Swain Michael, Funabashi Martha, Wong Arnold, Pagé Isabelle, Sibbritt David, Peng Wenbo

机构信息

Faculty of Health, University of Technology Sydney, Sydney, New South Wales, Australia.

Department of Chiropractic, Faculty of Science and Engineering, Macquarie University, Sydney, New South Wales, Australia.

出版信息

Aust J Rural Health. 2019 Feb;27(1):34-41. doi: 10.1111/ajr.12447. Epub 2019 Feb 5.

Abstract

OBJECTIVE

To determine the prevalence and clinical management characteristics of chiropractors practising in urban and rural or remote Australia.

DESIGN

A cross-sectional analysis of the Australian Chiropractic Research Network project data.

SETTING

Nationally representative sample of registered chiropractors practising in Australia.

PARTICIPANTS

Chiropractors who participated in the Australian Chiropractic Research Network project and answered a question about practising in urban or rural or remote areas in the practitioner questionnaire.

MAIN OUTCOME MEASURE

The demographics, practice characteristics and clinical management of chiropractors.

RESULTS

The majority of chiropractors indicated that they practise in urban areas only, while 22.8% (n = 435) practice in rural or remote areas only and 4.0% (n = 77) practice in both urban and rural or remote areas. Statistically significant predictors of chiropractors who practice in rural or remote areas, as compared to urban areas, included more patient visits per week, practising in more than one location, no imaging facilities on site, often treating degenerative spinal conditions or migraine, often treating people aged over 65 years, frequently treating Aboriginal and Torres Strait Islander people and frequently using biomechanical pelvic blocking or the sacro-occipital technique.

CONCLUSION

A substantial number of chiropractors practice in rural or remote Australia and these rural or remote-based chiropractors are more likely to treat a wide range of musculoskeletal cases and include an Indigenously diverse group of patients than their urban-located colleagues. Unique practice challenges for rural or remote chiropractors include a higher workload and a lack of diagnostic tools. Chiropractors should be acknowledged and considered within rural or remote health care policy and service provision.

摘要

目的

确定在澳大利亚城市及农村或偏远地区执业的脊医的患病率及临床管理特征。

设计

对澳大利亚脊医研究网络项目数据进行横断面分析。

背景

在澳大利亚执业的注册脊医的全国代表性样本。

参与者

参与澳大利亚脊医研究网络项目并在从业者调查问卷中回答了有关在城市、农村或偏远地区执业问题的脊医。

主要观察指标

脊医的人口统计学、执业特征及临床管理情况。

结果

大多数脊医表示他们仅在城市地区执业,而22.8%(n = 435)仅在农村或偏远地区执业,4.0%(n = 77)在城市及农村或偏远地区均有执业。与城市地区相比,在农村或偏远地区执业的脊医的统计学显著预测因素包括每周看诊患者更多、在多个地点执业、现场没有影像设施、经常治疗退行性脊柱疾病或偏头痛、经常治疗65岁以上人群、经常治疗原住民和托雷斯海峡岛民以及经常使用生物力学骨盆阻滞或枕下技术。

结论

相当数量的脊医在澳大利亚农村或偏远地区执业,与城市地区的同行相比,这些在农村或偏远地区执业的脊医更有可能治疗广泛的肌肉骨骼疾病病例,且患者群体包括不同的原住民。农村或偏远地区脊医面临的独特执业挑战包括工作量较大以及缺乏诊断工具。在农村或偏远地区的医疗保健政策和服务提供中,应认可并考虑脊医的作用。

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