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Providing health care services to children involves a dimension not often encountered in rendering care to adults. Not only must the child's needs and concerns be addressed, but those of the child's parents as well. The child doesn't have educational bias, is usually simple to care for, and will respond immediately to physiologic changes that enhance life expression. The parents may require more attention to further their knowledge and understanding of health. This article addresses the issue of how to know if a child's health is improving, and how to assure the parent of this.
There are two models of health: biomedical and social science. The biomedical model refers to physical symptom status and laboratory tests. The social science model refers to the individual's functional status; the ability to utilize the uniqueness of one's environment and one's experience. It also includes the changes to one's perception, the ability to make healthier choices, and improvement in one's overall quality of life.
Health, by definition refers to optimal function physically, mentally and socially, not merely the absence of disease and infirmity. The social science indicators must be considered to fully assess health. Since chiropractic is a non-medical discipline, it is all the more vital that our chiropractic and health assessments not be largely based upon medical indicators. In the course of chiropractic care, it is common for parents to remark that their child's disposition has improved, that he learns better in school, that she is more at peace, that he reacts to stress more effectively, sleeps better, and that in general he is more able to function without restriction. These are all indicators of health. At times a presenting symptom may not reduce or be eliminated, but the child's health will be improving in a variety of other ways.
It is important to eliminate inconsistencies in our philosophy, clinical approach, and communication. If we wish to assist in the restoration of spinal integrity (with its associated enhancement of health and well being) through specific adjustment of vertebral subluxations, then our methods of outcome assessment must be consistent with this.
Is the spine healthier than at the entrance visit? What is the general trend, and what are the specifics at the time of re-evaluation? Is there a positive improvement in both the correction of subluxations and spinal integrity? And lastly, what is the child's personal assessment or the parent's opinion of the child's status in the following categories:
- Physical State
- Mental Emotional State
- Stress Evaluation
- Life enjoyment
- Overall Quality of life.