title: Patients' experiences and expectations of chiropractic care: a national cross-sectional survey.
abstract: BACKGROUND
  Not enough is understood about patients' views of chiropractic care. The aims of this research were to explore patients' experiences and expectations, their perceptions of benefits and risks, and the implications for chiropractors' continuing fitness to practise.
  
  
  METHODS
  Survey questions were formulated from existing literature, published guidance on good practice from the General Chiropractic Council, and from 28 telephone interviews and a small focus group with chiropractic patients using a semi-structured topic guide. In its final form, the survey elicited patients' ratings on expectations regarding 33 aspects of care. In a national cross-sectional survey, a number of sampling methods were required as a consequence of the low practitioner response rate.
  
  
  RESULTS
  In total, 544 completed questionnaires were received from chiropractic patients, a lower response rate than expected (8%). The two main benefits that patients reported regarding their chiropractic care were reduced pain (92%) and increased mobility (80%). Of respondents, 20% reported unexpected or unpleasant reactions to their treatment, most commonly tiredness or fatigue (32%), and extra pain (36%). In most cases they expressed low levels of concern about these reactions. Patients' expectations were met for most aspects of care. The four aspects of practice where expectations were least well met comprised: having more information on the cost of the treatment plan at the first consultation (80%); the chiropractor contacting the patient's general practitioner if necessary (62%); having a discussion about a referral to another healthcare practitioner (62%); and providing a method for confidential feedback (66%).
  
  
  CONCLUSIONS
  Overall, patients reported a high level of satisfaction with the benefits of their chiropractic care, although there is a likelihood of bias towards patients with a positive experience of chiropractic. There were no serious adverse reactions; however, patients reported concern about pain, tingling and numbness in the limbs after chiropractic. In general, patients' expectations were being well met.
authors: Department of Health Sciences, University of York, York, UK.
authors: Hugh
authors: H
authors: MacPherson
authors: Firefly Research & Evaluation and Visiting Fellow, Department of Health Sciences, University of York, York, UK.
authors: Elizabeth
authors: E
authors: Newbronner
authors: Firefly Research & Evaluation, North Yorkshire, UK.
authors: Ruth
authors: R
authors: Chamberlain
authors: Department of Health Sciences, University of York, York, UK.
authors: Ann
authors: A
authors: Hopton
keywords: Benefit; Chiropractic; Fitness to practice; Patients’ expectations; Patients’ experiences; Risk
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