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Wellness and the Practice of Chiropractic

Thursday, 31 May 2007 00:00

Introduction: Epidemiology indicates that the leading cause of morbidity and mortality in the US and other industrialized countries are from chronic disease. Furthermore, studies on health risk indicators/factors indicate that the best means of intervention is one of prevention that encompasses lifestyle modification under the auspices of wellness care 1 2. Chiropractors, with a vitalistic and holistic approach to patient care are well suited as providers under this new health paradigm. However, little has been published in the scientific literature about the attitudes, beliefs and practice activities of chiropractors within the context of wellness care 3. To address this concern, the author undertook a survey to study these variables and describes the results below.

Methods: A cross-sectional survey was performed of Doctors of Chiropractic from the membership of the International Chiropractic Pediatric Association (ICPA) (Media, PA, USA). The survey was pilot tested by 15 chiropractors via e-mail and following revisions, the final survey posted on-line. A total of 1495 members of the ICPA were invited by e-mail transmission to participate in this survey study. The invitation to participate in the survey was time-sensitive that required the participants to complete the survey within 7 days of the invitation.

Survey Content: The survey was original in content. In addition to geographic information (i.e., gender, years in practice and chiropractic alma mater), an examination of the attitudes, beliefs and practice activities of chiropractors were surveyed within the context of wellness care.

Statistical Analysis: All data were entered into manually exported from Word Document (Microsoft Word, Microsoft Corp) to a spreadsheet (Excel, Microsoft Corp) and analyzed using descriptive statistics.

Results: Of the 1784 ICPA members invited to participate in the survey study, 545 accessed the link provided for the questionnaire and 377 completed the survey. Based on accessed questionnaires, the response rate was 69.17 percent. Of the 377 survey participants, 236 were females and 141 males.

For brevity, the rest of the survey results are tabulated and provided in the Tables 1-4 below.

AECC

Cleveland

CMCC

LACC

LCCW

Life

Logan

6

25

25

10

8 +13

54

23

McTimoney

National

NHSU

NYCC

PA

Palmer

PCCW

1

14

33

31

1

56

8

RMIT

Parker

Sherman

SCCC

Sydney

Texas

UBCC

2

24

10

1

1

3

3

WSCC

UTQR

Glamorgan

McQuarrie

12

7

1

5

Table 1. The number of survey participants based on their chiropractic alma mater

 

% Source of Income

0%

10%

20%

30%

40%

50%

60%

70%

80%

90%

100%

# of practitioners with income from Insurance

57

46

18

24

26

48

46

61

34

15

1

# of practitioners with income from Cash

1

17

39

60

43

45

24

26

17

52

53

Table 2. Source of income of survey participants

 

Years in Practice

<1

1-5

6-10

11-15

16-20

21-25

26-30

31-36

N

7

153

117

44

28

19

8

1

% of Participants

1.86

40.58

31.03

11.67

7.43

5.04

2.12

0.27

Table 3. Years in practice of participants

 

Questionnaire

Response (%)

1.  Wellness is defined by the Presidents Council on Physical Fitness and Sports as “a multidimensional state of being describing the existence of positive health in an individual as exemplified by quality of life and sense of well-being.”

Strongly Agree: 15
Agree: 62
Neutral: 14
Disagree: 6
Strongly Disagree: 3

Yes (%)

No (%)

2.  Regardless of your definition of “wellness care”, do you think the practice of chiropractic (in general) falls under the paradigm of wellness care?

96

4

3.  Do you advise patients on the detriments of certain lifestyle behaviors such as smoking?

98

2

4.  Do you advise patients on the positive aspects of a healthy diet?

99

1

5.  Do you advise patients on the benefits of regular exercise?

99

1

6.  Do you advise patients on stress management?

92

8

7.  Do you advise patients that regular chiropractic care are part of living a healthy lifestyle?

98

2

8.  Do you advise patients that receiving regular chiropractic adjustments are part of living a healthy lifestyle?

98

2

9.  Do you advise patients that receiving regular chiropractic care enhances visceral function?

94

6

10.  Do you advise patients that receiving regular chiropractic care increases neurological function?

97

3

11.  Do you advise patients that receiving regular chiropractic care increases joint movement for musculoskeletal benefits?

97

3

12.  Do you advise patients that receiving regular chiropractic care prevents illness and/or enhance immune system function?

98

2

13.  Do you advise patients that receiving regular chiropractic care enhances general physical performance?

98

2

14.  Do you advise patients that receiving regular chiropractic care enhances mental performance and well being?

93

7

15.  Do you advise patients that receiving regular chiropractic care enhances social well being?

94

6

16.  Do you advise patients that receiving regular chiropractic care enhances intellectual functioning?

81

19

17.  Do you advise patients that receiving regular chiropractic care enhances emotional wellbeing?

92

8

18.  Do you advise patients that receiving regular chiropractic care enhances spiritual wellbeing?

58

42

19.  Do you advise patients that receiving regular chiropractic care enhances performance in the workplace?

92

8

20.  Do you advise patients that receiving regular chiropractic care enhances posture?

98

2

21.  Do you believe that “wellness care” is allowed under the existing fee-for-service healthcare payment system ((i.e., third-party payers, HMO/PPO healthcare coverage, worker’s compensation, Medicare, etc.)?

8

92

Table 4. The attitudes, beliefs and practice activities of chiropractors on wellness care.

 

Conclusions: The issues surrounding wellness care and chiropractic are many and complex. Initial data on the attitudes, beliefs and practice activities of chiropractors within the context of wellness care as defined in this survey study indicate that indeed, chiropractors believe and do practice concepts of wellness care under the paradigm of chiropractic care.

References

  1. Brownson RC, Remington PL, Davis JR, eds. American Public Health Association, Chronic Disease Epidemiology and Control, 2nd ed. United Book Press, Washington, DC: 1998.
  2. Centers for Disease Control and Prevention. Chronic Diseases and Their Risk Factors: The Nation’s Leading Causes of Death, 1999.
  3. Hawk C, Long CR, Perillo M, Boulanger KT. A survey of US chiropractors on clinical preventive services. J Manipulative Physiol Ther. 2004 Jun;27(5):287-98

Joel Alcantara, BSc, DC 1

  1. Research Director, International Chiropractic Pediatric Association, Media, PA, USA and Private Practice of Chiropractic, San Jose, CA, USA

Presented at WFC Annual Conference. Portugal, May 2007.

Presented at Pangea Conference Pediatric Integrative Medicine Conference 2007.