Quality of Life Changes in a Disadvantaged, Underserved Chiropractic Patient Population: A Retrospective Case Series Report
Ron Kirk M.A., D.C., Kathryn Hoiriis B.S., D.C., Steven Mirtschink D.C., Helen Luong
Journal of Vertebral Subluxation Research ~ April 15, 2005 ~ Pages 1-3
Background: Characterized by high rates of morbidity, mortality and very poor quality of life, homeless individuals’ health has been the subject of an increasing number of studies. Despite the increasing interest in the health and quality of life in homeless populations, a Mantis literature search revealed no studies have been published assessing the impact of chiropractic care on the health and quality of life of homeless individuals. The purpose of this descriptive case series report is to assess whether chiropractic care provided by student interns at the outreach shelter clinic helped to improve the quality of life of patients from the women’s shelter.
Methods: Case records from the Ellis Street Women’s Shelter were reviewed and 10 case records which contained pre and post SF-36 scores were included. Because the population of the women’s shelter is extremely transient, many of the shelter’s residents are not under systematic care for the 4 weeks required to complete post SF-36 health surveys. The patients in the cases studied received chiropractic care administered by chiropractic interns for a period of at least four weeks. The care included performance of complete case histories, physical examinations, chiropractic evaluations, lifestyle and nutritional counseling and a series of chiropractic adjustments. Some of the patients had also attended spinal exercise classes taught by student interns. This retrospective case series report utilizes pre and post intervention scores on the SF-36 health survey as the primary form of assessment. Pre and post SF-36 scores were compared using paired two tailed t-tests with the data entered into an Excel spreadsheet.
Results: SF-36 mean scores of patients from the shelter increased in each of the scales and summary scores. Results must be interpreted cautiously because of the small number of participants, but it is interesting to note that the vitality scale (VT) score improved 22 points. This increase was enough to achieve statistical significance (p equals 0.02) despite the small numbers of patients involved.
Conclusion: It appears that chiropractic care holds promise and merits further investigation as one means of enhancing the quality of life in the homeless population studied in this case series report.
Key Words: quality of life, health disparities, disadvantaged population, chiropractic care, homeless individuals