1489 Occupational health history taking attitudes and behaviours of chiropractic interns

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IntroductionOccupational illness and injuries are a major health burden, with the large majority being musculoskeletal related. Because of this, health care providers, such as chiropractors, should understand the role of work in health conditions. This pilot study assessed the occupational history taking attitudes and behaviours of chiropractic interns for one year, including the effect of a brief occupational health history training program.MethodsAll chiropractic interns at one clinic location completed questionnaires assessing their attitudes and perceptions regarding documenting occupational history of their patients. Each intern enrolled in the study for two or more trimesters also participated in an hour-long training session on taking an occupational history. The supervising clinician independently evaluated charting behaviours of interns for the duration of the study.ResultTwenty interns participated for 4 to 12 months. The supervising clinician assessed the interns’ level of documenting occupational history for 202 new patient or re-examination visits. Patient’s current occupation was documented in 93% of these visits, but a detailed occupational history was documented in only 11% of these visits despite the chief complaint being related to their occupation 39% of the time. After the first group of interns completed training, documentation of the relationship between occupation and chief complaint increased from 20% of visits to 57%. When interns assessed their own recordkeeping practices, all interns reported asking about current occupation for most patients, but indicated their other occupational history taking and documentation behaviours can vary.DiscussionWhile documenting current occupation was relatively high among the chiropractic interns, additional detailed occupational information was not usually included in their documentation. Additional training on occupational history taking did not substantially change those behaviours, but did increase the interns relating the chief complaint to the patient’s work.

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