Department of Chiropractic, Université du Québec à Trois-Rivières, 3351 boul. Des Forges, Trois-Rivières, QC, G8Z 4M3, Canada.
Canadian Memorial Chiropractic College, 6100 Leslie St, Toronto, ON, M2H 3J1, Canada.
Chiropr Man Therap. 2020 Sep 8;28(1):46. doi: 10.1186/s12998-020-00336-3.
Approximately 50% of patients who receive spinal manipulative therapy (SMT) experience some kind of adverse event (AE), typically benign and transient in nature. Regardless of their severity, mitigating benign AEs is important to improve patient experience and quality of care. The aim of this study was to identify beliefs, perceptions and practices of chiropractors and patients regarding benign AEs post-SMT and potential strategies to mitigate them.
Clinicians and patients from two chiropractic teaching clinics were invited to respond to an 11-question survey exploring their beliefs, perceptions and practices regarding benign AEs post-SMT and strategies to mitigate them. Responses were analyzed using descriptive statistics.
A total of 39 clinicians (67% response rate) and 203 patients (82.9% response rate) completed the survey. Most clinicians (97%) believed benign AEs occur, and 82% reported their own patients have experienced one. For patients, 55% reported experiencing benign AEs post-SMT, with the most common symptoms being pain/soreness, headache and stiffness. While most clinicians (61.5%) reported trying a mitigation strategy with their patients, only 21.2% of patients perceived their clinicians had tried any mitigation strategy. Clinicians perceived that patient education is most likely to mitigate benign AEs, followed by soft tissue therapy and/or icing after SMT. Patients perceived stretching was most likely to mitigate benign AEs, followed by education and/or massage.
This is the first study comparing beliefs, perceptions and practices from clinicians and patients regarding benign AEs post-SMT and strategies to mitigate them. This study provides an important step towards identifying the best strategies to improve patient safety and improve quality of care.
大约有 50%接受脊柱手法治疗（SMT）的患者会出现某种不良反应（AE），通常是良性且短暂的。无论其严重程度如何，减轻良性 AE 对于改善患者体验和护理质量都很重要。本研究旨在确定脊医和患者对 SMT 后良性 AE 的信念、看法和处理方法，以及潜在的减轻方法。
我们邀请了两家脊医教学诊所的临床医生和患者回答了一个 11 个问题的调查，以探讨他们对 SMT 后良性 AE 及其减轻方法的信念、看法和处理方法。使用描述性统计分析对答复进行了分析。
共有 39 名临床医生（回应率为 67%）和 203 名患者（回应率为 82.9%）完成了调查。大多数临床医生（97%）认为良性 AE 会发生，82%的临床医生报告说自己的患者曾经历过一次。对于患者，55%报告在 SMT 后出现良性 AE，最常见的症状是疼痛/酸痛、头痛和僵硬。虽然大多数临床医生（61.5%）报告在治疗患者时尝试了一种缓解策略，但只有 21.2%的患者认为他们的临床医生尝试了任何缓解策略。临床医生认为患者教育最有可能减轻良性 AE，其次是 SMT 后进行软组织治疗和/或冰敷。患者认为拉伸最有可能减轻良性 AE，其次是教育和/或按摩。
这是第一项比较脊医和患者对 SMT 后良性 AE 及其减轻方法的信念、看法和处理方法的研究。本研究为确定改善患者安全性和提高护理质量的最佳策略提供了重要的一步。
