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Nursing Evaluation01:15

Nursing Evaluation

The evaluation stage signals the end of the nursing process. The nurse gathers evaluative data to assess whether or not the patient has attained the expected results. Whereas the nurse collects data in the nursing assessment to identify the patient's health concerns, the evaluation stage data determines if the indicated health issues are resolved. Evaluative data collection includes two sections: the data acquired to evaluate patient outcomes and the time criteria for data collection.
Section...

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Chiropractic: a critical evaluation.

Edzard Ernst1

  • 1Complementary Medicine, Peninsula Medical School, Universities of Exeter & Plymouth, Exeter, United Kingdom. edzard.ernst@pms.ac.uk

Journal of Pain and Symptom Management
|February 19, 2008
PubMed
Summary

Chiropractic care, while popular, lacks scientific evidence for its core concepts like subluxation and spinal manipulation. Its effectiveness is unproven for most conditions beyond back pain, with questionable safety and cost-effectiveness.

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Area of Science:

  • Integrative Medicine
  • Evidence-Based Practice
  • Health Policy

Background:

  • Chiropractic, defined as drug-free healing, has a global practice base with significant annual expenditure.
  • The profession is characterized by internal conflicts stemming from its mystical origins and differing approaches among practitioners.
  • This evaluation critically examines chiropractic's history, concepts, practice, research, efficacy, safety, and cost.

Observation:

  • Chiropractic's foundational concepts, particularly subluxation and spinal manipulation, are not scientifically validated.
  • While primarily focused on musculoskeletal issues like back and neck pain, some chiropractors treat a wider range of conditions.
  • The review utilized a narrative approach for chiropractic literature and systematic reviews for efficacy, safety, and cost assessments.

Findings:

  • Chiropractic spinal manipulation demonstrates efficacy only for back pain, with limited evidence for other conditions.
  • Adverse effects are common, ranging from mild to serious complications of unknown frequency.
  • The cost-effectiveness of chiropractic care has not been conclusively established.

Implications:

  • The scientific basis of chiropractic concepts requires further rigorous investigation.
  • Clinical practice should align with evidence-based guidelines, focusing on conditions with proven benefits.
  • Further research is needed to clarify the safety profile and cost-effectiveness of chiropractic interventions.