Objective: To evaluate an e-mail self-completion questionnaire to determine if it obtains the opinions of chiropractors on the perceived safety of chiropractic care for pregnant patients while determining the types of treatments employed when seeing pregnant patients, and the referral patterns of pregnant patients between chiropractors and other professionals.
Design: Pilot e-mail self-completion survey in embedded and attached forms.
Subjects: Twenty-six Canadian and Australian chiropractors with varying levels of experience selected as part of a convenience sample.
Methods: E-mails containing the 12-question survey and instructions for completion were sent. A 1-week cut-off for return of the surveys was employed and a reminder message was sent to non-respondents 4 days after the initial e-mail. Percentages of each response were determined.
Results: A response rate of 69% was obtained. All of the respondents indicated seeing fewer than 11 pregnant patients per month. Spinal manipulative therapy was opined to be a safe therapy for use on pregnant patients, although certain co-morbidities reduced the number of respondents willing to use this particular treatment on such patients. Most of the respondents used spinal manipulative therapy, soft tissue therapy, exercise therapies and patient education on pregnant patients with back and/or neck pain, headaches, or benign vertigo. Nearly all of the respondents indicated that spinal manipulative therapy was an appropriate treatment for those conditions during pregnancy. Almost all of the respondents indicated there was no evidence that pregnant patients are at increased or decreased risk for vertebrobasilar incident after cervical spinal manipulative therapy and pregnancy is not a contraindication for this therapy. Referral of pregnant patients between chiropractors and massage therapists was the most common scenario followed by referrals between chiropractors and family medical doctors.
Conclusions: This pilot study yielded useful information about the questionnaire and will allow it to be modified so it can yield more useful information in future studies. The questionnaire appears to accomplish the stated goals. A larger pilot study is necessary to evaluate changes made to the questionnaire. This was a preliminary study and the results should be interpreted cautiously as numerous sources of bias were noted, particularly the sampling method employed.
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