The quality of life of chiropractors using PROMIS: Results from a practice-based research network
Introduction
Since its inception in 1895, chiropractic has become the largest and most recognized alternative form of healthcare in the United States. Of the practitioner-based complementary and alternative medicine (CAM), chiropractic is the most popular and highly utilized by adults and children [1], [2]. In 2007, adults in the United States spent $33.9 billion out of pocket on CAM visits to practitioners and purchases of CAM products, classes, and materials. About three-quarters of both visits to CAM practitioners and total out-of-pocket costs spent on CAM practitioners were associated with manipulative and body-based therapies [3].
As with all healthcare professions, the practice of chiropractic can be personally meaningful and rewarding. However, it is also physically and psychologically demanding. The quality of life (QoL) of various healthcare professionals such as medical doctors [4], dentists [5], nurses and midwives [6] and physical therapists [7] have been examined in the scientific literature. What the literature has shown is that the compromised wellbeing of healthcare providers have negative consequences to patient care, job satisfaction, professionalism and personal self-care and safety [8].
To the best of our knowledge, no study has examined the QoL of Doctors of Chiropractic (DCs). To address this deficit, we examined the QoL of chiropractors using the Patient Reported Outcomes Measurement Information System (PROMIS) within a practice-based research network (PBRN).
Section snippets
Methods
We report our analysis on the QoL of DCs that were involved in two independent studies. Ethics approval for both studies was approved by Life University (Marietta, GA). One involved the measurement of pediatric QoL using the PROMIS-25 pediatric self-report for QoL and the other involved the use of the PROMIS parent-proxy items banks. The data was originally collected within a chiropractic PBRN. Inclusion criteria for DC participation in these PBRN studies were: (a) the DC must be in good
Statistical analysis
The socio-demographic data was analyzed using descriptive statistic and reported as frequencies and percentages, means and standard deviations. The PROMIS data was analyzed using the PROMIS Assessment Center [12], a free, online data collection tool to securely capture participant data and provide real-time scoring. For each PROMIS short form (i.e., anxiety, physical functioning, pain interference, global physical and mental health), a scoring table was developed to associate the raw scores to
Results
A convenience sample of 148 DCs (125 female; 23 males) comprised our study population. Their average age was 33.09 years (range: 25–53 years; SD = 5.36) and have a mean practice experience of 6.05 years (range: <1–22 years; SD = 4.69). The majority of responders graduated from the Palmer University System (N = 34) followed by Life University (N = 30), Northwester Health Sciences University (N = 16), Cleveland College – Kansas City (N = 8), Canadian Memorial College of Chiropractic (N = 7),
Discussion
In terms of our socio-demographic findings, our DC responders comprised a younger group with an average age of 33.09 years. According to Data USA [17], the mean age of DCs in the United States is 43.7 years. According to National Board of Chiropractic Examiners, the proportion of chiropractors that have been in practice for more than 15 years has been steadily increasing with the most recent data at 63.8% [18]. In terms of this context, our responders have less practice experience with a mean
Conclusion
We examined the QoL of chiropractors using the PROMIS-29 and PROMIS Global health measures. We found the QoL of DCs higher relative to a representative sample of the US population and a cohort of healthcare workers (i.e., nurse and physicians). We support and encourage further research to determine the covariates associated with improvement and detriments to the QoL of chiropractors.
Funding
This study was funded by the International Chiropractic Pediatric Association (Media, PA, USA) and Life Chiropractic College West (Hayward, CA, USA)
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