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    Motion palpation used as a postmanipulation assessment tool for monitoring end-feel improvement : a randomized controlled trial of test responsiveness
    (Elsevier BV, 2009-09) Lakhani, Ekta; Nook, Brian; Haas, Mitchell; Docrat, Aadil
    A tenet of motion palpation theory is the ability to confirm postadjustive segmental end-feel improvement (EFI). Only one previous trial has evaluated the responsiveness of EFI; this was a study of the thoracic spine. The purpose of this study was to evaluate the responsiveness of postadjustive end-feel for evaluating improvement in putative segmental spinal motion restriction after spinal manipulative therapy (SMT) of the cervical spine.

    Methods

    A prospective, blinded, randomized placebo-controlled pilot trial was conducted with 20 symptomatic and 10 asymptomatic participants recruited from a chiropractic teaching clinic. The treatment group received SMT, and the control group received placebo detuned ultrasound. Responsiveness was evaluated as the etiologic fraction (% of cases with EFI attributable to SMT) and as the sensitivity and specificity of change.

    Results

    For the entire sample, the etiologic fraction was 63% (P = .002), sensitivity was 93%, and specificity was 67%. For symptomatic participants, a strong relationship appeared to exist between receiving SMT and EFI (etiologic fraction = 78%, P = .006; sensitivity = 90%; specificity = 80%). A strong relationship was not found for asymptomatic participants (etiologic fraction = 40%, P = .444; sensitivity = 100%; specificity = 40%), where EFI was recorded frequently, whether participants received SMT or detuned ultrasound.

    Conclusion

    The findings of this study showed that motion palpation of end-feel assessment appears to be a responsive postmanipulation assessment tool in the cervical spine for determining whether perceived motion restriction found before treatment improves after SMT. This observation may be limited to symptomatic participants.
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    A survey of patient satisfaction of the DUT Homoeopathic Community Health Centre (DUT HCHC)
    (2022-05-13) Adandé, Adhiéman Sihle; Couchman, Ingrid; Brijnath, Shraddha
    Background Patient satisfaction is a vital area of research concerning the quality of healthcare. Satisfied patients are more likely to benefit from their healthcare, keep their appointments and comply with medical regimes such as proper medication upon given instructions from their healthcare practitioner (Hills and Kitchen, 2007: 243). Herr (2008) conducted a similar study on patient satisfaction at the Homoeopathic Community Health Centre (HCHC) at Durban University of Technology (DUT). Although there has been renovation at the community health since then, more than five years have passed without any evaluation. Patient satisfaction is a patient-focused indicator of healthcare services. Therefore, evaluating patient satisfaction is a good criterion for analysing the quality and relationship between patients and healthcare practitioners. Therefore, patient dissatisfaction is a significant factor for changing healthcare services or complaints against a healthcare practitioner (Miri, Nejad and Soltani, 2016: 89). Thus, continuous improvement in healthcare quality is a daily goal for all healthcare services, such as clinics and professionals who work in healthcare. To thrive in a competitive marketplace, it is essential for healthcare organisations and their practitioners to recognise that viewing patients as customers and improving customer satisfaction has direct implications on healthcare quality (Harding and Taylor 2010: 928; Stavins 2006:29). This study evaluated patient’s feedback to create a patient satisfaction survey for use at the HCHC at DUT continually. Aim The aim of this study was to conduct a patient’s satisfaction of the service provided at the DUT HCHC, with the purpose to identify shortfalls/gaps such as to improve every aspect of patient satisfaction, which positively contributes to the overall treatment and service being provided at the DUT HCHC. Methodology The sample group of the first 70 patients that consulted at the DUT HCHC between July 2020 and March 2021, that voluntarily participated in this study were included in the study by means of convenience sampling. The use of a self-administered questionnaire to establish patient satisfaction was applied. No names were required and all data has been kept strictly confidential. This information will subsequently be used to improve the quality of the service provided at this facility and increase the degree of patient satisfaction experienced. Results In this study there was generally a high degree of satisfaction with the healthcare and services provided. Areas of particularly high satisfaction were, Patient’s arrival at the community health centre where they were both promptly and politely greeted, as well as the overall interaction between the student Homoeopath, Administrative staff as well as the Clinician on duty and the patient. Areas that demonstrated lower degree of satisfaction were advertising by media and signage, signage, toilet accessibility for disabled patients and parking. Conclusion The feedback from the patient satisfaction survey will subsequently serve to improve the quality of the service provided at the DUT HCHC and increase the degree of patient satisfaction experience.