BMC Complementary and Alternative Medicine | |
Patients’ expectations of private osteopathic care in the UK: a national survey of patients | |
Ann P Moore2  Adam Fiske2  Carol A Fawkes2  Vinette Cross2  Laura M Bottomley2  Matthew Hankins1  Anne Mandy2  CM Janine Leach2  | |
[1] Faculty of Health Sciences, University of Southampton, Southampton, Highfield SO17 1BJ, UK;Clinical Research centre for Health Professions, University of Brighton, Aldro Building, 49 Darley Road, BN20 7UR, Eastbourne, UK | |
关键词: Osteopathic medicine; Musculoskeletal manipulations; Expectations; Survey; Questionnaires; | |
Others : 1229901 DOI : 10.1186/1472-6882-13-122 |
|
received in 2013-01-23, accepted in 2013-05-22, 发布年份 2013 | |
【 摘 要 】
Background
Patients’ expectations of osteopathic care have been little researched. The aim of this study was to quantify the most important expectations of patients in private UK osteopathic practices, and the extent to which those expectations were met or unmet.
Methods
The study involved development and application of a questionnaire about patients’ expectations of osteopathic care. The questionnaire drew on an extensive review of the literature and the findings of a prior qualitative study involving focus groups exploring the expectations of osteopathic patients. A questionnaire survey of osteopathic patients in the UK was then conducted. Patients were recruited from a random sample of 800 registered osteopaths in private practice across the UK. Patients were asked to complete the questionnaire which asked about 51 aspects of expectation, and post it to the researchers for analysis.
The main outcome measures were the patients-perceived level of expectation as assessed by the percentage of positive responses for each aspect of expectation, and unmet expectation as computed from the proportion responding that their expectation “did not happen”.
Results
1649 sets of patient data were included in the analysis. Thirty five (69%) of the 51 aspects of expectation were prevalent, with listening, respect and information-giving ranking highest. Only 11 expectations were unmet, the most often unmet were to be made aware that there was a complaints procedure, to find it difficult to pay for osteopathic treatment, and perceiving a lack of communication between the osteopath and their GP.
Conclusions
The findings reflected the complexity of providing osteopathic care and meeting patients’ expectations. The results provided a generally positive message about private osteopathic practice. The study identified certain gaps between expectations and delivery of care, which can be used to improve the quality of care. The questionnaire is a resource for future research.
【 授权许可】
2013 Leach et al.; licensee BioMed Central Ltd.
【 预 览 】
Files | Size | Format | View |
---|---|---|---|
20151103035540614.pdf | 285KB | download | |
Figure 1. | 70KB | Image | download |
【 图 表 】
Figure 1.
【 参考文献 】
- [1]Department of Health: The musculoskeletal services framework. London: DH Publications; 2006.
- [2]National Institute for Health and Clinical Excellence: Low Back Pain: early management of persistent non-specific low back pain. NICE Clinical guideline CG88. London: NICE; 2009.
- [3]Fawkes C, Leach J, Mathias S, Moore AP: Standardised data collection within osteopathic practice in the UK: development and first use of a tool to profile osteopathic care in 2009. 2010. http://www.osteopathy.org.uk/uploads/standardised_data_collection_finalreport_24062010.pdf: webcite General Osteopathic Council
- [4]Thompson AG, Sunol R: Expectations as determinants of patient satisfaction: concepts, theory and evidence. Int J Qual Health Care 1995, 7(2):127-141.
- [5]Yardley L, Sharples K, Beech S, Lewith G: Developing a dynamic model of treatment perceptions. J Health Psychol 2001, 6:269.
- [6]Georgy EE, Carr EC, Breen AC: Met or matched expectations: what accounts for a successful back pain consultation in primary care? Health Expect 2013, 16:143-54.
- [7]Goldstein MS, Morgenstern H, Hurwitz EL, Yu F: The impact of treatment confidence on pain and related disability among patients with low-back pain: results from the University of California, Los Angeles, low-back pain study. Spine J 2002, 2(6):391-399. discussion 399–401
- [8]Verbeek J, Sengers MJ, Riemens L, Haafkens J: Patient expectations of treatment for back pain: a systematic review of qualitative and quantitative studies. Spine 2004, 29(20):2309-2318.
- [9]Rutishauser C, Esslinger A, Bond L, Sennhauser FH: Consultations with adolescents: the gap between their expectations and their experiences. Acta Paediatr 2003, 92(11):1322-1326.
- [10]Tsao JC, Meldrum M, Bursch B, Jacob MC, Kim SC, Zeltzer LK: Treatment expectations for CAM interventions in pediatric chronic pain patients and their parents. Evid Based Complement Alternat Med 2005, 2(4):521-527.
- [11]Vieder JN, Krafchick MA, Kovach AC, Galluzzi KE: Physician-patient interaction: what do elders want? J Am Osteopath Assoc 2002, 102(2):73-78.
- [12]Mead N, Roland M: Understanding why some ethnic minority patients evaluate medical care more negatively than white patients: a cross sectional analysis of a routine patient survey in English general practices. BMJ 2009, 339:b3450.
- [13]Moffett JA, Underwood MR, Gardiner ED: Socioeconomic status predicts functional disability in patients participating in a back pain trial. Disabil Rehabil 2009, 31(10):783-790.
- [14]Georgy EE, Carr EC, Breen AC: Back pain management in primary care: patients’ and doctors’ expectations. Qual Prim Care 2009, 17(6):405-413.
- [15]May S: Patients’ attitudes and beliefs about back pain and its management after physiotherapy for low back pain. Physiother Res Int 2007, 12(3):126-135.
- [16]Coulter A: What do patients and the public want from primary care? BMJ 2005, 331(7526):1199-1201.
- [17]Bishop F, Yardley L, Lewith G: A systematic review of beliefs involved in the use of complentary and alternative medicine. Journal of Health Psychology 2007, 12(6):851-867.
- [18]Richardson J: What patients expect from complementary therapy: a qualitative study. Am J Public Health 2004, 94(6):1049-1053.
- [19]Sirois FM, Gick ML: An investigation of the health beliefs and motivations of complementary medicine clients. Soc Sci Med 2002, 55(6):1025-1037.
- [20]Bishop FL, Barlow F, Coghlan B, Lee P, Lewith GT: Patients as healthcare consumers in the public and private sectors: a qualitative study of acupuncture in the UK. BMC Health Serv Res 2011, 11:129. BioMed Central Full Text
- [21]Strutt R, Shaw Q, Leach J: Patients’ perceptions and satisfaction with treatment in a UK osteopathic training clinic. Man Ther 2008, 13:456-467.
- [22]Linde K, Witt CM, Streng A, Weidenhammer W, Wagenpfeil S, Brinkhaus B, Willich SN, Melchart D: The impact of patient expectations on outcomes in four randomized controlled trials of acupuncture in patients with chronic pain. Pain 2007, 128(3):264-271.
- [23]Myers SS, Phillips RS, Davis RB, Cherkin DC, Legedza A, Kaptchuk TJ, Hrbek A, Buring JE, Post D, Connelly MT: Patient expectations as predictors of outcome in patients with acute low back pain. J Gen Intern Med 2008, 23(2):148-153.
- [24]Rubinstein SM, Knol DL, Leboeuf-Yde C, de Koekkoek TE, Pfeifle CE, van Tulder MW: Predictors of a favorable outcome in patients treated by chiropractors for neck pain. Spine (Phila Pa 1976) 2008, 33(13):1451-1458.
- [25]Fassaert T, van Dulmen S, Schellevis F, van der Jagt L, Bensing J: Raising positive expectations helps patients with minor ailments: A cross-sectional study. BMC Fam Pract 2008, 9:38. BioMed Central Full Text
- [26]Westmoreland JL, Williams NH, Wilkinson C, Wood F, Westmoreland A: Should your GP be an osteopath? Patients’ views of an osteopathy clinic based in primary care. Complement Ther Med 2007, 15(2):121-127.
- [27]Vincent C, Furnham A: Why do patients turn to complementary medicine? An empirical study. Br J Clin Psychol 1996, 35(Pt 1):37-48.
- [28]Licciardone J, Gamber R, Cardarelli K: Patient satisfaction and clinical outcomes associated with osteopathic manipulative treatment. J Am Osteopath Assoc 2002, 102(1):13-20.
- [29]Pincus T, Vogel S, Savage R: Patients’ satisfaction with osteopathic and GP management of low back pain in the same surgery. Comple Therap Med 2000, 8:180-186.
- [30]LoD D: High quality care for all: NHS next stage review final report. London: Department of Health; 2008.
- [31]Department of Health: White paper ’equity and excellence: liberating the NHS’. TheStationery Office; 2010. http://www.dh.gov.uk/en/Healthcare/LiberatingtheNHS/index.htm webcite
- [32]Leach CMJ, Cross V, Fawkes C, Mandy A, Hankins M, Fiske A, Bottomley L, Moore AP: Investigating osteopathic patients’ expectations of osteopathic care:the OPEn project. Full Reseach Report. London; 2011. GOsC http://www.osteopathy.org.uk/resources/research/Osteopathic-Patient-Expectations-OPEn-study/ webcite
- [33]Cross V, Leach CMJ, Fawkes CA, Moore AP: Exploring patients’ expectations of osteopathic care: a qualitative study. Health Expect, in press 2013.
- [34]Deyo R, Diehl A: Patient satisfaction with medical care for low back pain. Spine (Phila Pa 1976) 1986, 11:28-30.
- [35]Salmon P, Quine J: Patients’ intentions in primary care: Measurement and preliminary investigation. Psychol Health 1989, 3:103-110.
- [36]Kravitz R, Callahan E, Azari R: Assessing patients’ expectations in ambulatory medical practice. J Gen Intern Med 1997, 12:67-72.
- [37]Peck BM, Asch DA, Goold SD, Roter DL, Ubel PA, McIntyre LM, Abbott KH, Hoff JA, Koropchak CM, Tulsky JA: Measuring patient expectations: does the instrument affect satisfaction or expectations? Medical Care 2001, 39(1):100-108.
- [38]Boynton PM, Greenhalgh T: Selecting, designing and developing your questionnaire. BMJ 2004, 328:1321-1315.
- [39]Fowler F: Survey research methods. Thousand Oaks, CA: Sage Publications; 2009.
- [40]Fink A, Kosecoff J: How to conduct surveys. A step by step guide. 2nd edition. Thousand Oaks, CA: Sage Publications; 1998.
- [41]Sapsford R: Survey research. London: Sage publications; 1999.
- [42]Punch KF: Survey research. London: Sage Publications; 2003.
- [43]Gorsuch L: Factor analysis. Abingdon, Oxford: Routledge; 1998.
- [44]Staniszewska S, Ahmed L: The concepts of expectation and satisfaction: do they capture the way patients evaluate their care? J Adv Nurs 1999, 29(2):364-372.
- [45]Hoddinott SN, Bass MJ: The dillman total design survey method. Can Fam Physician 1986, 32:2366-2368.
- [46]Stone J: Risk, regulation and the growing marginalisation of CAM. Comple Therap Clinic Prac 2010, 16(1):1-2.
- [47]MacPherson H, Thomas K: Short term reactions to acupuncture–a cross-sectional survey of patient reports. Acupunc med: j Brit Med Acupunc Soc 2005, 23(3):112-120.
- [48]Reichheld F: The one number you need to grow. Harvard Business Review: Harvard Business Review; 2003.
- [49]General Osteopathic Council: Snapshot survey 2001. London: GOSC; 2001. http://www.osteopathy.org.uk/uploads/survey2snapshot_survery_results_2001.pdf webcite
- [50]Yardley L, Sharples K, Beech S, Lewith G: Developing a dynamic model of treatment perceptions. J Health Psychol 2001, 6(3):269-282.
- [51]Parsons S, Harding G, Breen A, Foster N, Pincus T, Vogel S, Underwood M: Will shared decision making between patients with chronic musculoskeletal pain and physiotherapists, osteopaths and chiropractors improve patient care? Fam Pract 2012, 29(2):203-212.