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当界限模糊时——探索医疗服务提供者对整脊跨专业护理和加拿大军队医疗服务的看法。

When boundaries blur - exploring healthcare providers' views of chiropractic interprofessional care and the Canadian Forces Health Services.

作者信息

Vogel Ellen, Mior Silvano A, Sutton Deborah, Côté Pierre, French Simon, Nordin Margareta, Laporte Audrey

机构信息

Faculty of Health Sciences, Ontario Tech University.

Canadian Memorial Chiropractic College.

出版信息

J Can Chiropr Assoc. 2021 Apr;65(1):14-31.

Abstract

INTRODUCTION

Musculoskeletal (MSK) conditions are primary reasons prohibiting Canadian Armed Forces (CAF) personnel from being deployed, with back pain the second most common activity-limiting condition. CAF provides a spectrum of services, including chiropractic care. There is a paucity of data related to chiropractic interprofessional care (IPC) within CAF healthcare settings.

METHODS

A qualitative study, using an Interpretative Phenomenological Analysis (IPA) approach, involving 25 key informant interviews explored factors that impact chiropractic IPC. We used a systematic but not prescriptive process, based on a thematic analysis, to interconnect data to develop meaning and explanation. Initially, we explained and interpreted participant's experiences and meanings. Next, we used extant literature and theory, together with expert knowledge, to explain and interpret the meanings of participants' shared accounts.

RESULTS

We present findings central to the domain, Role Clarity, as described in the IPC Competency Framework. Our findings call for strengthening IPC specific to MSK conditions in the CAF, including an examination of gatekeeping roles, responsibilities and outcomes.

CONCLUSION

It is timely to investigate models of care that nurture and sustain inter-provider relationships in planning and coordinating evidence-based chiropractic care for MSK conditions, within the CAF, and its extended referral networks.

摘要

引言

肌肉骨骼疾病是加拿大武装部队人员无法部署的主要原因,背痛是第二常见的限制活动的疾病。加拿大武装部队提供一系列服务,包括脊椎按摩治疗。在加拿大武装部队医疗环境中,与脊椎按摩治疗跨专业护理(IPC)相关的数据很少。

方法

采用解释性现象学分析(IPA)方法进行定性研究,对25名关键信息提供者进行访谈,探讨影响脊椎按摩治疗IPC的因素。我们基于主题分析,采用系统但非规定性的过程,将数据相互联系起来,以形成意义和解释。最初,我们解释和阐释参与者的经历和意义。接下来,我们运用现有文献和理论,结合专业知识,来解释和阐释参与者共同叙述的意义。

结果

我们呈现了IPC能力框架中所描述的“角色清晰”领域的核心发现。我们的研究结果呼吁加强加拿大武装部队中针对肌肉骨骼疾病的IPC,包括审查把关角色、职责和结果。

结论

现在是时候研究护理模式了,这种模式能够在为加拿大武装部队及其扩展转诊网络中的肌肉骨骼疾病规划和协调循证脊椎按摩治疗时,培养和维持提供者之间的关系。

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