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Theses and dissertations (Health Sciences)

Permanent URI for this collectionhttp://ir-dev.dut.ac.za/handle/10321/12

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Subject: search.filters.subject.Chiropractic--Practice

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    The knowledge, attitudes and perceptions of qualified chiropractors and physiotherapists in South Africa regarding the other professional practice
    (2022) Ravidutt, Micaela; Maharaj, Sonill Sooknunan; Prince, Cleo
    Chiropractors and physiotherapists treat patients that present with similar conditions. Arising from this, a sense of competition is perceived between these professionals, as both professions use similar methods of treatment when providing care to their patients. However, chiropractors and physiotherapists may belong to different health paradigms which influences how each profession approaches patient management. There is also an overlap between the roles of each profession in providing healthcare, as the methods of managing patients seem to be similar. This requires an investigation into the knowledge, attitudes and perceptions of qualified chiropractors and physiotherapists in South Africa regarding the other professional practice. This could potentially determine possible misconceptions and myths that the two professions have of each other’s practice. If identified and corrected, this could influence awareness within a multidisciplinary setting to enhance and promote holistic patient-centred care. Aim The aim of this study was to determine the knowledge, attitudes and perceptions of qualified chiropractors and physiotherapists in South Africa regarding the other professional practice. Methodology The research conducted was a quantitative study with a descriptive design which targeted qualified chiropractors and physiotherapists in South Africa. The research tool was an online questionnaire administered through an online platform named the QuestionPro Survey, which included questions and statements relating to the knowledge, attitudes and perceptions of the two professions regarding the other professional practice to meet the objectives of the study. The minimum sample size required for this study comprised of 116 chiropractors and 128 physiotherapists. The data obtained from each group were analysed separately and then a comparative analysis was done. An alpha value of 0.05 and a margin of error of 0.085 were assumed. Results Chiropractors and physiotherapists in South Africa generally demonstrated good knowledge, positive attitudes, and positive perceptions toward the other profession. Both professions were familiar with the other profession’s scope of practice. Chiropractors achieved a mean knowledge score of 75.7%, whereas physiotherapists obtained 59.7% on their knowledge of the examinations performed by the other profession. Chiropractors obtained an average score of 85.3% and physiotherapists achieved 72.0% on their knowledge of the treatment modalities that the other profession may perform for a patient. Both professions had good knowledge about the conditions that the other profession may treat, with chiropractors having achieved a mean knowledge score of 82.4% and physiotherapists having obtained a score of 77.3%. A total of 75.0% of chiropractors and 72.1% of physiotherapists considered the other profession to be competent in examining neuromusculoskeletal conditions. More chiropractors (82.8%) than physiotherapists (70.0%) believed the other profession to be competent in treating neuromusculoskeletal conditions. Each profession acknowledged the role of the other profession within the South African healthcare system. Of the sampled professions, 81.9% of chiropractors and 55.3% of physiotherapists had referred patients to the other profession. It was found that 69.8% of chiropractors, compared to 32.1% of physiotherapists, had patients referred to them by the other profession. A total of 69.0% of chiropractors and 55.3% of physiotherapists were in agreement that they would like to work closely with the other profession. Conclusion In South Africa, chiropractors and physiotherapists had good knowledge and positive attitudes and perceptions of each other’s practices. There also appeared to be a referral relationship between these professions. However, the challenges between the professions were limited and there was insufficient inter-professional awareness and exposure when practicing within the different health paradigms. Therefore, inter-professional education between chiropractors and physiotherapists of their practices as part of the university curriculum within a multidisciplinary team should be enhanced and encouraged. This would enhance and encourage inter-professional relationships between the two professions, thus promoting the delivery of holistic patient-centred care.
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    Practice characteristics of chiropractic delegates attending the World Federation of Chiropractic's 12th Biennial Congress, 2013
    (2016) Bezuidenhout, Lauren Leigh; O'Connor, Laura; Shaik, Junaid
    Background Chiropractic is practiced in over 100 countries and is considered to be the fastest growing health care profession internationally. Several studies investigating the practice characteristics of chiropractors have been conducted in selected countries, however, as far as is known, no study has been conducted where chiropractors from countries across the globe are assessed for their practice characteristics in order to determine if regional differences exist. Gaining insight into chiropractic practice and its influencing factors, relating to both the profession itself and the chiropractor can enable organisations such as the World Federation of Chiropractic to have a greater understanding of how chiropractors are currently practicing and how the profession is being utilised by the public. Improved insight into the profession provides a baseline description for the public and other health care practitioners to fully comprehend what chiropractors can offer to the health care system. Aim: The aim of this study was to determine the demographic profile and practice characteristics of chiropractic delegates attending the World Federation of Chiropractic’s 12th Biennial Congress 2013. Method A pre-validated questionnaire and letter of information and consent was distributed to all registered chiropractic delegates (N = 406) attending the World Federation of Chiropractic Congress in Durban, Kwa-Zulu Natal 2013. The questionnaire was part of the delegate packages and they self-selected to participate. Due to a low response rate at the congress, the questionnaire was made available electronically on Survey Monkey®, for six weeks after the congress. Questions relevant to this study were coded, reduced where necessary and utilised for data analysis with IBM SPSS Version 21. Descriptive data was then summarised and presented using tables and graphs. The study was approved by the Durban University of Technology’s Institutional Research Ethics committee. Results: The response rate was 34.72%, with 52.5% being female, mean age was 42 (SD ± 13years, and all seven geographical regions were represented. The majority of respondents were from Africa (51.1%), followed by North America (22.7%) then Europe (14.2%). South Africa (48.6%) was the most represented country. Respondents held either a Master’s degree in Chiropractic (51.8%) or a Doctor of Chiropractic (DC) degree (48.2%). The mean years since graduating as a chiropractor was 15.7 years (SD ± 3.6). The majority of respondents (71.2%) engaged in full-time clinical practice, for between 5 to 15 years (39.8%) with 51.4% purporting to have an evidence based philosophical approach to practice. The majority (72.5%) viewed the role of a chiropractor in the health care system as a primary health care practitioner with a focused scope of practice. The majority of respondents (n = 52) personally treated 50 patients or less per week, with approximately one third of the respondents (n = 34) having high volume practices (>100 patients weekly). The respondents favoured being one of two chiropractors (36.9%) in a practice setting followed by sole practices (31.6%). The top chiropractic technique utilised was the diversified technique (74.5%) followed by extremity adjusting (68.8%). Various adjunctive, active and passive, axillary techniques were utilised in the daily management of patients. The patient demographics were majority female (55.7%), older than 30 years of age (66.7%) and Caucasian (77%), complaining of head, neck, mid-back and low back pain, which was mostly acute in nature. Trends suggested that females were more likely to select an evidence-based philosophical orientation than males. Females were more likely to delegate adjunctive therapies to non-chiropractic assistants (p = 0.029), and favoured sending patients to a physical therapist (p = 0.018), whereas males were more likely to refer to nutritionists and paediatricians (p = 0.030 and p = 0.038, respectively). Females were less likely to utilise mobilisation techniques (p = 0.008), massage therapy (p = 0.018) and nutritional counselling (p = 0.032). In terms of age, those selecting an evidence-based approach were significantly older than those who adopted a mixer approach to practicing (p = 0.002). The mean age of the respondents, irrespective of the region, was not significantly associated with the number of patients treated per week (p = 0.377) or the hours worked per week (p = 0.474). Trends show that the number of years spent in practice differed among the regions with North American chiropractors spending more years in practice than those from Europe and Australasia. The respondents from South Africa spent fewer years in practice (15 years or less) than respondents from Asia, Australasia, Europe and North America. Geographic region was not significantly associated with practice setting (p = 0.182). The only chief complaint that differed between regions was patients presenting with headaches accompanied by neck pain (p = 0.007), where Asian and North American respondents reported seeing less patients than their colleagues from other regions. Trends suggested that the respondents who attained a Masters of Technology in Chiropractic were more inclined to select a mixer orientation whereas those with a DC qualification selected an evidence-based philosophical approach. Conclusion: The WFC congress provided a platform to successfully determine the demographic profile and practice characteristics of chiropractors from various regions. Similar demographics were evident, with males no longer showing dominance within the profession. Chiropractors adopting an evidence-based and mixer philosophical orientation are synonymous in the role that they play in the health care system and display similarities in chiropractic practice and patient management. Investigating chiropractors who adopt a straight philosophical approach would be beneficial as it will allow for better comparison of demographics and practice characteristics. It is evident that selected demographics do influence how one would opt to practice, with regional differences showing that the chiropractic profession in South Africa is still relatively young.