Theses and dissertations (Health Sciences)
Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12
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Item Perceptions and experiences of elderly patients receiving chiropractic care in the Durban Metropolitan area(2024) Claire de Lange, Holly; Varatharajullu, DesireeBackground: The elderly population experience a significant musculoskeletal burden. Both the population and their healthcare burdens are expected to increase due to the elderly’s extended life expectancies. This escalating healthcare burden falls to the public healthcare sector, on which the majority of the population relies in the South African context. The current experiences of elderly individuals in this public system are poor due to the disease centred approach implemented in care. Chiropractic care implements a patient-centred approach to healthcare which is more suitable to meet the needs of this vulnerable population. Chiropractic care effectively manages musculoskeletal conditions; however, it remains largely underutilised by the public. In South Africa, Chiropractic Care’s public presence is limited to two university clinics due to the outdated legislature restricting the profession in the public healthcare sector. This limits the public exposure to Chiropractic Care’s non-invasive and non-pharmacological approach for managing musculoskeletal pain. There is limited research in both the local and international contexts into the perceptions and experiences towards Chiropractic Care from the elderly’s perspective, therefore demonstrating the value of additional research into this topic. Aim: This study aimed to explore the perceptions and experiences of elderly individuals receiving Chiropractic Care in the Durban Metropolitan area. Method: This qualitative study was conducted utilising an exploratory, descriptive approach. A random-purposive sampling of 11 elderly individuals with at least one previous Chiropractic Care experience was implemented. Semi-structured interviews were performed to provide insights into the perceptions and experiences of this population. Thematic analysis was performed using the Tesch method. Results: Thematic analysis extracted six themes, including understanding of Chiropractic Care; factors influencing the pursuit of Chiropractic Care; the impact of care on the elderly experience; insights provided through lifetime experiences; the impacts of age on the elderly experience; and the attraction of an alternative healthcare approach. Conclusion: This analysis indicated that although understanding of Chiropractic Care was limited by this population, all elderly participants shared positive perceptions of Chiropractic Care. A lack of language eloquence was observed when participants discussed Chiropractic terminology. New Chiropractic Care experiences have the potential to change the previous negative perceptions, while misinformation can be combated through patient education. Recommendation-based pursuit of Chiropractic Care is insufficient, and a focus on exposing new individuals to Chiropractic Care through alternative methods, such as community outreach, should be prioritised. The patient-centred approach in Chiropractic Care created a positive healthcare experience for the elderly individuals in this study. The elderly felt age had minimal impact on the Chiropractic Care they were provided, compared to the age based discrimination they experienced in the mainstream public sector. When the clinical care provided to the elderly is substandard, the negative perceptions of ageing and the ability to successfully access care are reinforced. Chiropractic care was viewed by the elderly as a superior healthcare alternative to the pharmacological and surgical options they were traditionally offered.Item The clinical experience of registered master's chiropractic students in the management of elderly patients during their practicum(2021-05-27) Naidoo, Kimone; Varatharajullu, Desiree; Sibiya, M.N.Background The elderly population is increasing rapidly worldwide. As elderly individuals age, their physiological process changes, which means that elderly patients present differently, as a result of associated comorbidities and challenges in their physical and cognitive function, and thus the management of an elderly patient could present as a challenge. Registered master’s degree chiropractic students complete a theoretical elderly module during the fifth year of their studies, while entering their clinical practicum. The registered master’s degree chiropractic students need to acquire and refine their clinical skills, as well as apply their theoretical knowledge during their clinical practicum. The healthcare system in South Africa has limited knowledge on the management of elderly patients. Therefore, the aim of this study has been to determine the clinical experiences of registered master’s degree chiropractic students during their clinical practicum with respect to the management of elderly patients. Aim of the study The aim of the research study was to explore and discuss the experiences of registered chiropractic master degree students in the management of elderly patients presenting at the Chiropractic Day Clinic at the Durban University of Technology. Method A qualitative, exploratory, descriptive study was conducted, using an interpretivist paradigm. The master’s degree chiropractic students, who had been clinically active for four months during their clinical practicum, were interviewed to establish their experiences in the management of elderly patients during their clinical practicum. The interviews were semi-structured and conducted in English, and later transcribed verbatim into a Microsoft® Word document. The transcripts were then analysed using Tesch’s eight steps of thematic analysis to establish the themes, categories and codes. Results Of the twenty-four registered master degree chiropractic students, twelve (50%) participated in the study. There were five overarching themes that emerged from the data: attitudes and opinions towards the management of an elderly patient; important aspects of the management towards an elderly patient; positive aspects of managing an elderly patient; challenges faced during the management of an elderly patient and suggestions to improve a chiropractic clinical practicum. The participants discussed the importance of having practical experience in managing an elderly patient and the significance of elderly patients being interactive with their own management protocols. The participants elaborated that they did have a sufficient basis to manage elderly patients. Many participants mentioned that they needed to be more involved in the management of elderly patients. Most of the participants felt that managing elderly patients was beneficial and they suggested that learning about elderly patients earlier in their studies would be beneficial to their clinical experience of managing elderly patients. Conclusion This is the first South African study that has been conducted on registered master’s degree chiropractic students’ clinical experiences in managing elderly patients during their clinical practical. This study will add to the existing body of literature and enable other registered master’s degree chiropractic students and new graduate chiropractors to have a better understanding of the management of elderly patients.