Hawk C, Dusio M E
Institute of Graduate Studies and Research, Palmer College of Chiropractic, Davenport, IA 52803, USA.
J Manipulative Physiol Ther. 1995 Feb;18(2):57-64.
To gain information on the issue of scope of chiropractic practice, particularly in relation to primary care and prevention.
A survey was administered by mail to a random sample of 753 U.S. chiropractors.
The sampling frame was stratified into eight geographic regions with approximately equal numbers of D.C.'s to ensure that all areas of the U.S. were represented.
Chiropractors listed in the National Directory of Chiropractic, 1993-4 edition, comprised the sampling frame.
Of the 753 D.C.'s sampled, 492 completed surveys, for a response rate of 65.3%. The majority of respondents (90.4%) considered themselves primary care practitioners. Over 80% were accessible to patients at all times. Only 4.1% accepted payment in cash only. Fifty-eight percent did a regional physical exam, 29.0% a complete physical, and 71% a complete health history on every patient. Referrals to M.D.'s/D.O.'s were made by 78.1% and received by 46.0% within the last 3 months, although fewer than 20% included reports with referrals. Prevention practices related directly to musculoskeletal problems were most often designated as important to discuss with patients: lifting techniques (78.0%), postural education (76.4%), fitness exercise (69.3%) and injury prevention (68.3%).
In general, respondents demonstrated a number of practice characteristics associated with primary care. However, it appears that they could further strengthen their position by routinely accompanying referrals with reports, and by increasing their emphasis on prevention, especially in areas not directly related to musculoskeletal conditions.
获取有关脊椎按摩疗法实践范围问题的信息，尤其是与初级保健和预防相关的信息。
通过邮件对753名美国脊椎按摩师进行随机抽样调查。
抽样框架被分为八个地理区域，每个区域的脊椎按摩师数量大致相等，以确保涵盖美国所有地区。
1993 - 4版《国家脊椎按摩师名录》中列出的脊椎按摩师构成了抽样框架。
在抽取的753名脊椎按摩师中，492人完成了调查，回复率为65.3%。大多数受访者（90.4%）认为自己是初级保健从业者。超过80%的受访者随时可供患者就诊。只有4.1%的受访者只接受现金支付。58%的受访者对每位患者进行区域体格检查，29.0%进行全面体格检查，71%进行完整的健康史询问。在过去3个月内，78.1%的受访者会将患者转诊给医学博士/ osteopathic医师（D.O.），46.0%的受访者接收过转诊患者，不过只有不到20%的转诊包含报告。与肌肉骨骼问题直接相关的预防措施最常被认为对与患者讨论很重要：举重技巧（78.0%）、姿势教育（76.4%）、健身锻炼（69.3%）和伤害预防（68.3%）。
总体而言，受访者表现出一些与初级保健相关的实践特征。然而，他们似乎可以通过在转诊时常规附上报告，并更加重视预防，特别是在与肌肉骨骼疾病无直接关系的领域，来进一步巩固自己的地位。
