Jennifer R. Jamison

Stress: The chiropractic patients' self-perceptions☆

BACKGROUND Psychosocial stress pervades modern life and is known to have an impact on health. Pain, especially chronic back pain, is influenced by stress. Various strategies have been shown to successfully reduce stress and its consequences. OBJECTIVES This study explores stress as a potential disease trigger among chiropractic patients. METHOD A descriptive study was undertaken to ascertain the stress perceptions of chiropractic patients. Purposive sampling of chiropractic practices and convenience sampling of patients was undertaken. Patients were allocated to 1 of 4 groups according to their presentation: acute, chronic biomechanical, fibromyalgia, or maintenance care. Participating patients were requested to complete a questionnaire. RESULTS Of the 138 patients attending 1 of 10 participating chiropractic clinics, more than 30% regarded themselves as moderately to severely stressed, and over 50% felt that stress had a moderate or greater effect on their current problem. Some 71% of patients felt it would be helpful if their chiropractic care included strategies to help them cope with stress, and 44% were interested in taking a self-development program to enhance their stress management skills. CONCLUSION Patient perceptions are known to be important in health care. A number of chiropractic patients perceive they are moderately or severely stressed. Interventions that reduce stress, or even the patients perception of being stressed, may be construed as valid, non-specific clinical interventions. It may be timely for chiropractors to actively contemplate including stress management routinely in their clinical care protocols.

Dietary diversity: a case study of fruit and vegetable consumption by chiropractic patients

BACKGROUND A distinct health advantage has been linked with eating a wide variety of fresh fruit and vegetables. OBJECTIVE This study explores the diversity of fruits and vegetables consumed by chiropractic patients and inquires into their preferred purchasing patterns. METHOD A case study that included patients attending 24 chiropractic practices in 5 states and the Australian Capital Territory was undertaken. Seven hundred eighty-two patients were asked to complete a questionnaire providing general information about their life-style and particular information about the number of servings of fruits and vegetables that they usually consumed. RESULTS Although overall chiropractic patients reported adhering to a number of healthy life-style behaviors, participants in this study would benefit from eating a greater diversity of fruits and vegetables. CONCLUSION In view of the substantial health benefits associated with eating a wide variety of fruits and vegetables, it is suggested that chiropractic patients be encouraged to follow a color code system for purchasing their fresh produce.

Chapter 90 – Saw Palmetto (Serenoa repens)

Is it safe to take? There are no known drug interactions. Any prostate problem should be diagnosed by your personal physician before taking this supplement. Do not use saw palmetto if you have prostate cancer; the effect on prostate cancer is not known. Saw palmetto should not be taken by children. It’s important to discuss herb use with your health care professional, especially if you take prescription drugs. Also see box below.

A psychological profile of fibromyalgia patients: A chiropractic case study

BACKGROUND Fibromyalgia is a chronic condition characterized by widespread musculoskeletal pain and tenderness. Reversible modulation of the pain threshold is believed to contribute to the pathogenesis of this condition, and psychosocial stress is known to alter the pain threshold. OBJECTIVE To describe and compare the psychological profile of fibromyalgia patients attending chiropractic clinics in Australia. SETTING Chiropractic clinics located in 5 Australian states and the Australian capital territory with practices in inner city, suburban, coastal, and rural areas were included. SUBJECTS Chiropractic patients with acute and chronic biomechanical conditions, fibromyalgia, and who were undergoing maintenance care were included in the study. METHOD A case study to explore the psychological profile of fibromyalgia patients was undertaken. The Distress and Risk Assessment Method (DRAM) and Sense of Coherence (SOC) questionnaires were used to ascertain and compare the distress, sense of coherence, and manageability levels of patients with fibromyalgia with patients having maintenance chiropractic care. Purposive sampling of practitioners and convenience sampling of patients fulfilling the studys inclusion criteria were undertaken. Patients were asked to complete two questionnaires and chiropractors to complete one questionnaire and an interview. RESULTS While more than half of the patients in the fibromyalgia group were distressed, fewer than 1 in 7 maintenance patients were found to be distressed according to the DRAM questionnaire. With several individual exceptions, fibromyalgia patients also tended to have lower SOC and manageability scores than the maintenance group. CONCLUSION This study supports the view that fibromyalgia may represent a problem of coping with various environmental stresses, including psychosocial stresses. However, owing to individual variation, a diagnosis of fibromyalgia at the clinical level does not accurately predict whether a particular patient is distressed or has a low SOC score. Screening of fibromyalgia patients may help determine whether intensive counseling and stress management by the chiropractor or another health professional should be contemplated.

CLINICAL COMMUNICATION:: The Essence of Chiropractic?

ABSTRACT One explanation for the failure of chiropractic to have achieved functional inclusion in the Australian health referral system is its failure to have gained scientific legitimation according to the standards designed by government bodies and organized medicine. Adoption of a model predicated upon the assumptions of the mechanistic paradigm, while conducive to evaluation of chiropractic according to biomedical standark, does however not necessarily result in best practice standards. It is atgued that bestpactice standark can only be achieved when skilled clinical communication, based upon the assumptions of the holistic paradigm, is coupled with the scientific rigor of the mechanistic paradigm in selecting and implementing manual techniques.

Chapter 72 – Goldenseal (Hydrastis canadensis)

Description: Goldenseal is an herbaceous perennial with bright yellow roots growing out of a thicker rhizome. Leaves are doubly serrated, palm-shaped, and have 5 to 7 lobes. Younger plants usually have only one leaf, while a fork with two leaves is more common on mature plants. A single, small white flower blooms in April or May as the leaves are unfolding. Its red, berry-like fruit develops by mid to late summer. Goldenseal can also spread through its rhizome, forming dense colonies.

Mineral Deficiency: A Dietary Dilemma?

This study aimed to ascertain whether a group of young Australians meet the recommended dietary intake (RDI) for calcium, zinc and iron and to explore the effect of dietary modifications to correct any mineral deficiencies on dietary fat consumption. A group of healthy young Australian adults being trained as health professionals were requested as part of their coursework to undertake a computer-assisted analysis of their diet. Participants were requested to assess their usual diet with respect to their calcium, iron and zinc consumption and to undertake dietary changes to correct any deficiencies detected. Computer analysis was then used to describe the impact of such dietary modifications on the fat consumption profile of participants. Other measures taken included body mass index (BMI), waist measurement and the zinc tally test. Although all the males in this study had an adequate dietary intake of iron, almost half the females had an inadequate intake. Over half of the participants failed to meet the ...

Herbal and nutrient supplementation practices of chiropractic patients: an Australian case study.

BACKGROUND Escalating interest in alternative health care has resulted in increased use of nutritional supplements and herbs by consumers. A number of these neutraceuticals interact with prescription drugs and may have adverse effects. OBJECTIVE This study explored the extent to which chiropractic patients are likely to inform their chiropractic practitioner of their medication practices. METHOD A case study that included patients attending 21 chiropractic clinics in 5 states and the Australian Capital Territory was undertaken. Seven hundred fifty-eight patients provided information on their nutritional and herbal supplementation practices. Data were collected using a questionnaire that inquired about general life-style and sought particular information about self-initiated and professionally recommended medication practices. A list of medications that could influence coagulation was provided. Patients were specifically requested to indicate whether they had informed their chiropractor about any of the medications, herbs, or nutrients they were taking. RESULTS More than 1 in 3 of the chiropractic patients in this study were taking, either on the advice of a health professional or, more often, on their own initiative, a nutritional supplement and/or herb. Yet, chiropractors were only occasionally informed about the medication practices of their patients. CONCLUSION In view of the potential health risks and drug interactions, chiropractors should routinely inquire whether their patients are taking herbs or nutritional supplements.

A psychological profile of chiropractic patients: an australian case study

BACKGROUND The efficiency and efficacy of the chiropractic consultation would be enhanced if patients requiring additional psychological assistance could be identified. Distressed patients and those with a low sense of coherence and/or manageability score may benefit from a more prolonged chiropractic consultation or may require specialist referral. OBJECTIVE This exploratory study sought to ascertain whether categorization within a particular chiropractic management group could serve as a red flag to alert the practitioner to the likelihood of special patient needs. RESEARCH METHOD A case study to explore the psychological profile of chiropractic patients was undertaken. The DRAM (Distress and Risk Assessment Method) and SOC (Sense of Coherence) questionnaires were used to ascertain the distress and sense of coherence and manageability levels of acute, chronic and maintenance chiropractic patients. Purposive sampling of practitioners and convenience sampling of patients fulfilling the studys inclusion criteria was undertaken. Patients were requested to complete two and chiropractors to complete one questionnaire and an interview. RESULTS Ten chiropractors and 142 patients participated in the study. Of participating patients, 38% had a chronic biomechanical problem, 23% were acute, and 39% were maintenance patients. Acute, chronic and maintenance patients were spread along the entire spectrum of the SOC and manageability scale. Of the 130 patients who completed the DRAM section of the questionnaire, over one in five were distressed. CONCLUSION Due to the small sample size and the diversity of results it was not possible to identify particular groups of chiropractic patients who require additional consultation time or referral. This study did however demonstrate that some chiropractic patients are distressed and consequently it is important that chiropractors know when to manage and when to refer anxious or depressed patients.

MIND-BODY MEDICINE: THE EVOLVING SCIENCE OF CHIROPRACTIC CARE

he relationship between mind and body in health care has long been debated. Four perspectives dominate discussion (1). The physical monist view denies the existence of mental processes. Epiphenomenalists, on the other hand, recognize mind but deny the possibility that mental processes may trigger behavioral events. The dualism of psychophysical parallelism considers that mind and body do not interact even though events in one sphere may be associated with corresponding events in the other. This view has been conducive to the development of a reductionist medical science. Such a positivist scientific paradigm, while suitable for evaluation of chiropractic techniques, is incompatible with chiropractic philosophy. A perspective more acceptable to traditional chiropractic thinking is the interactionist view which suggests that mind and body interact and that the body dominates such communication. Recent research demonstrates that mental processes and physical functioning are mutually and bidirectionally interactive (2-4). While such findings may constitute a medical revolution, this data merely corroborates traditional chiropractic thinking.