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Case Study with Relevant Psychosocial, Cultural and Ethical Considerations
Case study
Trigger 1 “Jeff” Part A
3,000 word written case study on the management of chiropractic patient (from selected trigger case) with a focus on relevant psychosocial, cultural and ethical considerations
Case History
A 44 Year Old Male Teacher with intermittent non-specific low back pain. No associated leg symptoms.
3 year recurring history following a fall at work, worse over last 6 months.
No red flags present
MRI (3 months ago) NAD – (nothing abnormal detected)
Had x10 physio sessions (manual treatment) through insurance – no effect
Yellow flags present, see below
Social history
2 children (10 and 7)
Currently going through a divorce with wife
Normally plays football (5 a side – non-competitive) weekly but not attended for 8 weeks due to low back pain
Occupational History
Been a teacher for 10 years, 6 months ago promoted to head of geography “very stressful, too high a work load”
Had the last 3 weeks off work “work being unsupportive”
Part B
Jeff scored as high risk on the STarT Back Tool
Jeff scored 60 out of 70 on the Bournemouth Questionnaire
Jeff states he has no confidence in ability to carry out his ADLs including football and work
Jeff does not feel that he will get better and that nothing will help “maybe surgery”
Jeff is very worried about his back “serious damage”
Although the MRI was normal a “bulging Disc” was shown “this is serious!”
The physiotherapist told him it is “a disc bulge” and that he shouldn’t bend forward or do any sports at the minute “should I stop forever?” “Exercise is not safe, cause’s further damage”
In addition Jeff states – “making me blue” “bit depressed”
Has suffered over the last 5 years with mild depression and anxiety.
Jeff states his sleep is now being affected by “everything”.
Patients states “cant carry on like this, what’s the point, no one cares”
Jeff denies suicidal thoughts
Part C
You have been treating Jeff x4 per week over the last 2 weeks
Jeff initially states feeling better following sessions “feels like someone cared and listened for the first time”. He also feels more “confident” in his back. His Bournemouth questionnaire is now 40/70.
However at week 3 Jeff has a flare up “lifting a box at work” and his symptoms and mindset return to his original presentation. He states he has lost his motivation for your management plan and Jeff’s GP has referred him for “chronic pain management” at a local hospital.
You now feel emotionally drained and do not look forward to seeing Jeff. You start to feel that Jeff is exaggerating his pain and worry if your beliefs will impact the therapeutic relationship and outcome.
Key points
- Relationship between anxiety and depression
- Fear
- Catastrophizing
- Bournemouth questionnaire
- Bulging disc
- Patient expectation
- Imagining
- Reassure the patient
- Screening Tool, how effective
- When we think a referral is required, To whom
- How to meet patient’s expectation
- Doctor patient relationship
- Placebo
- Trust between patient and Chiro
- Lifestyle
- Jeff should definitely return to work
- Red flags and yellow flags
- What is the epidemiology
- ICE (idea, concerns and expectation)
- Effective listening and communication
- patient education -use of simple language with the patient – the difference between advice and information
- use of words
- Shared decision on the care plan – The patient is an active decision maker
- Confidence
- What do you recommend Jeff should do, what kind of exercise
Gender Pay Gap
The Cause and Effect Essay should culminate into at least four (4) full double-spaced typed pages in length (approximately 1900-2100 Words).
Six (6) pages maximum. These pages must be single-sided with 1 inch margins and 12 point Times New Roman font. Also, the paper must
adhere to MLA formatting conventions, which include:
• The top left of the first page: your name, your instructor’s name, the course title, and the due date.
• Your last name and the page number should appear at the top right corner of every page.
• The title of your paper must be centered on the first line after your identifying information and should not be bolded, underlined, italicized, or in a different font/font size.
The Cause and Effect Essay will be assessed based on the following criteria: 1)structure, 2)content, 3)grammar and 4) MLA formatting.
Proofread carefully! And know that length MATTERS—essays that do not conform to at least six (6) full double-spaced pages will be reduced in connection with the length that is provided. Review the uploaded “Checklist for Evaluating Essays” link under the “Course Documents” tab.
Provide at least five (5)hard source (peer-reviewed research) examples.
American Imperialism and Expansion
Purpose: History is about clearly and concisely analyzing sources (evidence).
The key is not just repeating information (facts), but rather making a convincing argument (thesis) for what those facts mean.
Without an argument, readers will not understand why you are telling them about a historical event, person, or idea.
An analytical argument is not simply a forceful statement. Instead, historical analysis is like arguing a case in a court of law.
You must use specific examples and explain how they support your thesis. Few of you will write about history professionally, but everyone should develop the skills of effective professional communication, and the ability to critically evaluate claims, information, and sources.
Topic: Based upon your reading of the provided primary sources and on information from the lectures and The American Pageant, explain which interpretation of U.S. imperial expansion is most convincing. Pick only ONE. Your response MUST include a logically constructed thesis statement (argument) within the first paragraph, followed by analysis and explanation of your historical examples through the rest of the paper.
Mere description is not sufficient. You must use at least THREE primary sources and TWO secondary sources. Your textbook and course
lectures are acceptable secondary sources. Primary sources are sources that come from the historical period, not explanations written later.
These have been provided in this assignment packet. Pro tip: explain not only the strengths of the argument you find most convincing, but also address its potential weaknesses.