What puts the adverse in ‘adverse events’? Patients’ perceptions of post-treatment experiences in osteopathy – A qualitative study using focus groups

Rajendran, Dévan; Bright, Philip; Bettles, Steven; Carnes, Dawn; Mullinger, Brenda

doi:10.1016/j.math.2012.02.011

Cited by 24 publications

(10 citation statements)

References 28 publications

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“…Research investigating patients’ experiences during, and as a result of, their treatment has tended to focus on the: patient-therapist interaction [ 6 , 7 ], clinical environment [ 8 ], satisfaction with treatment [ 9 ], and, efficacy of treatment outcomes [ 7 , 10 ]. The patients’ physical experience of their treatment (i.e.…”

Section: Introductionmentioning

confidence: 99%

Exploring the construct validity of the Patient Perception Measure – Osteopathy (PPM-O) using classical test theory and Rasch analysis

Mulcahy

Vaughan

2015

Chiropr Man Therap

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BackgroundEvaluation of patients’ experience of their osteopathic treatment has recently been investigated leading to the development of the Patient Perception Measure – Osteopathy (PPM-O). The aim of the study was to investigate the construct validity of the PPM-O.MethodsPatients presenting to osteopathy student-led teaching clinics at two Australian universities were asked to complete two questionnaires after their treatment: a demographic questionnaire and the PPM-O. Confirmatory factor analysis (CFA) and Rasch analysis were used to investigate the construct validity of the PPM-O.ResultsData from the present study did not fit the a-priori 6-domain structure in the CFA. Modifications to the 6-domain model were then made based on the CFA results, and this analysis identified two factors: 1) Education & Information (9 items); and 2) Cognition & Fatigue (6 items). These two factors were Rasch analysed individually. Two items were removed from the Cognition & Fatigue factor during the analysis. The two factors independently were unidimensional.ConclusionsThe study produced a 2-factor, 13-item questionnaire that assesses the patients’ perception of their osteopathic treatment using the items from a previous questionnaire. The results of the current study provide evidence for the construct validity of the PPM-O and the small number of items makes it feasible to implement into both clinical and research settings. Further research is now required to establish the measures’ validity in a variety of patient populations.Electronic supplementary materialThe online version of this article (doi:10.1186/s12998-015-0055-x) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Exploring the construct validity of the Patient Perception Measure – Osteopathy (PPM-O) using classical test theory and Rasch analysis

Mulcahy

Vaughan

2015

Chiropr Man Therap

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“… 57 In the CST theory, such transient symptom aggravation, tiredness, and the described emotional release reactions are usually understood as positive vegetative responses to treatment, 28 which were also reported in studies of osteopathy, massage therapy, and acupuncture. 67 – 69 …”

Section: Discussionmentioning

confidence: 99%

Craniosacral Therapy for the Treatment of Chronic Neck Pain

Haller

Lauche

Cramer

et al. 2016

The Clinical Journal of Pain

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Objectives:With growing evidence for the effectiveness of craniosacral therapy (CST) for pain management, the efficacy of CST remains unclear. This study therefore aimed at investigating CST in comparison with sham treatment in chronic nonspecific neck pain patients.Materials and Methods:A total of 54 blinded patients were randomized into either 8 weekly units of CST or light-touch sham treatment. Outcomes were assessed before and after treatment (week 8) and again 3 months later (week 20). The primary outcome was the pain intensity on a visual analog scale at week 8; secondary outcomes included pain on movement, pressure pain sensitivity, functional disability, health-related quality of life, well-being, anxiety, depression, stress perception, pain acceptance, body awareness, patients’ global impression of improvement, and safety.Results:In comparison with sham, CST patients reported significant and clinically relevant effects on pain intensity at week 8 (−21 mm group difference; 95% confidence interval, −32.6 to −9.4; P=0.001; d=1.02) and at week 20 (−16.8 mm group difference; 95% confidence interval, −27.5 to −6.1; P=0.003; d=0.88). Minimal clinically important differences in pain intensity at week 20 were reported by 78% within the CST group, whereas 48% even had substantial clinical benefit. Significant between-group differences at week 20 were also found for pain on movement, functional disability, physical quality of life, anxiety and patients’ global improvement. Pressure pain sensitivity and body awareness were significantly improved only at week 8. No serious adverse events were reported.Discussion:CST was both specifically effective and safe in reducing neck pain intensity and may improve functional disability and the quality of life up to 3 months after intervention.

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“…Finally, statistics were not applied to the detailed results (Supplementary Material). However, contrary to what other studies indicate, it seems no differences in opinions were ascertained between the patient panel versus the medical and manual therapy panels (Supplementary Material) [40,41]. In order to improve the feasibility of the list in daily practice or research, it is proposed that: (1) the quality of the list of AE should be internationally tested for validity;…”

Section: Definitions Of Aementioning

confidence: 98%

Adverse events following cervical manipulative therapy: consensus on classification among Dutch medical specialists, manual therapists, and patients

Kranenburg

Lakke

Schmitt

et al. 2017

Journal of Manual & Manipulative Therapy

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Objectives: To obtain consensus-based agreement on a classification system of adverse events (AE) following cervical spinal manipulation. The classification system should be comprised of clear definitions, include patients' and clinicians' perspectives, and have an acceptable number of categories. Methods: Design: A three-round Delphi study. Participants: Thirty Dutch participants (medical specialists, manual therapists, and patients) participated in an online survey. Procedure: Participants inventoried AE and were asked about their preferences for either a three-or a fourcategory classification system. The identified AE were classified by two analysts following the International Classification of Functioning, Disability and Health (ICF), and the International Classification of Diseases and Related Health Problems (ICD-10). Participants were asked to classify the severity for all AE in relation to the time duration. Results: Consensus occurred in a three-category classification system. There was strong consensus for 16 AE in all severities (no, minor, and major AE) and all three time durations [hours, days, weeks]. The 16 AE included anxiety, flushing, skin rash, fainting, dizziness, coma, altered sensation, muscle tenderness, pain, increased pain during movement, radiating pain, dislocation, fracture, transient ischemic attack, stroke, and death. Mild to strong consensus was reached for 13 AE. Discussion: A consensus-based classification system of AE is established which includes patients' and clinicians' perspectives and has three categories. The classification comprises a precise description of potential AE in accordance with internationally accepted classifications. After international validation, clinicians and researchers may use this AE classification system to report AE in clinical practice and research.

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What puts the adverse in ‘adverse events’? Patients’ perceptions of post-treatment experiences in osteopathy – A qualitative study using focus groups

Cited by 24 publications

References 28 publications

Exploring the construct validity of the Patient Perception Measure – Osteopathy (PPM-O) using classical test theory and Rasch analysis

Exploring the construct validity of the Patient Perception Measure – Osteopathy (PPM-O) using classical test theory and Rasch analysis

Craniosacral Therapy for the Treatment of Chronic Neck Pain

Adverse events following cervical manipulative therapy: consensus on classification among Dutch medical specialists, manual therapists, and patients

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