Background: Patient perceptions may influence the effectiveness and utilization of healthcare interventions, particularly for complex health conditions such as sciatica or back-related leg pain (BRLP).
Objectives: To explore BRLP patients' perceptions of spinal manipulative therapy (SMT) and home exercise with advice (HEA).
Design: Qualitative study in a controlled clinical trial.
Method: Semi-structured interviews conducted after 12 weeks of treatment asked participants about
satisfaction with care and whether treatment was worthwhile. An interdisciplinary research team
conducted content analysis using qualitative data analysis software to identify and summarize themes.
Results: Of 192 trial participants, 174 (91%) completed interviews (66% female, age 57.0 ± 11.5 years).
Participants identified interactions with providers and staff, perceived treatment effects, and information
as key contributors to both their satisfaction and the worthwhile nature of treatment. HEA was liked for
its convenience and ability to foster an exercise habit. SMT was liked for specific aspects of the modality
(e.g. manipulation, stretching) and provider competency. Most participants reported no dislikes for SMT
or HEA, but some noted the dose/time commitment for SMT and discipline of HEA as least liked aspects
of the interventions.
Conclusions: The quality of patient-provider interactions, perceived treatment effects, and information
sharing influenced BRLP patients' satisfaction with care. Qualitative research describing patients' preferences can facilitate translation of study findings into practice and allow clinicians to tailor treatments
to facilitate compliance and satisfaction with care.
Public and professional awareness of the nature and consequences of psychological trauma has resulted in a greater interest in becoming trauma-informed. Complementary and alternative medicine (CAM) providers have begun to incorporate trauma-informed care in their practices. However, there is a lack of research exploring how training in trauma-informed care (TIC) personally and professionally transforms CAM providers. This descriptive phenomenological study explored the lived experience of transformation in CAM providers who participated in TIC training. Transformative learning theory (TLT) was used as the conceptual framework. Nine participants were interviewed, and their experiences of personal and professional transformation were analyzed using Giorgi’s analytic strategy. While the reasons for participating in TIC training varied, the shared experience included the recognition of behaviors of self and others as expressions of trauma, the importance of uncovering personal experiences of trauma, and acknowledgement of the need for change in how they worked with clients and patients. They described seeing new ways to address physical symptoms and the connections of symptoms to unresolved trauma. They also shared greater understanding of the boundary between retraumatizing and healing, for themselves and those they treat. Opportunities for positive social change include increasing awareness of the value of TIC training and the resulting personal and professional transformative consequences. The more understanding about the impact of trauma on health and well-being in all professions, the greater the chance of enhanced clinical health outcomes, lessening of provider burnout, and positive change in society
As a cancer survivor and educator, Dr. Barthels was motivated to create the "The Humans Behind Diseases" platform that can be used to provide learning opportunities for students to develop clinical empathy skills.
The authors developed a module called "Three Diets" to introduce students to the complex and extensive processes of human metabolism and its regulation in small chunks.
The presentation included examples of questions and answers that assist medical students in brief summaries and board-style questions and provided examples.