Theses and dissertations (Health Sciences)
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Item An investigation into the congruency between research perceived to be of relevance to chiropractors practicing in KwaZulu-Natal and the student research completed at the Durban University of Technology(2016) Van der Hulst, Nicolette; Van der Meulen, AnthonyBackground: The recent increase in the implementation of evidence-based practice (EBP) in the Chiropractic profession and the call within the profession for validation of its claims has seen a growing interest in good quality research. It is advocated that the future of Chiropractic research and thus the success of the profession is dependent on future practitioner and student research endeavours. It was the aim of this study to evaluate the student research agendas at the Durban University of Technology (DUT). Secondly, local Chiropractors were asked what they perceived to be clinically relevant Chiropractic research agendas. The agendas that were under-studied by the students, but perceived as important by the practitioners, were recommended as suggestions for more clinically relevant future student research. The intention of this was that future student research would become more congruent with local and international Chiropractic research trends. Methodolody: The study was a prospective exploratory study, which utilised a mixed method approach. Documented evidence giving an overview of student research completed at the DUT was combined with a qualitative questionnaire that was circulated to all Chiropractors practicing in KwaZulu-Natal. The questionnaire aimed to give insight into the research agendas perceived to be most relevant for future research by Chiropractic professionals. Incongruence between the research completed at the DUT and the research that is perceived to be of highest professional relevance by Chiropractors in KwaZulu-Natal was determined. All the Chiropractors practicing in KwaZulu-Natal as per the AHPCSA list received the questionnaire. A neutral third party at DUT collected the returned questionnaires and data analysis followed. The student research completed at the DUT between 1994 and 2013 was obtained from the Institutional Repository (IR) and library archives. These studies were descriptively analysed and compared with the respondents’ perceptions of clinically important Chiropractic research. Data analysis highlighted the overlap of agendas and gaps in the research. Following this was a statistical analysis of the questionnaire responses using Pearson’s chi square tests for two independent samples. A p value of ≤ 0.05 was considered as statistically significant. The results were interpreted using frequency tables and bar charts for categorical variables, while summary statistics such as mean, standard deviation and range were used for continuous variables. A descriptive comparison was performed to determine the congruency between the student research agendas and the research perceived to be of relevance by Chiropractors practicing in KwaZulu-Natal. Results: The response rate of 66.3 % was regarded as representative of the entire Chiropractic population. The overall practitioner perception of research was positive with 64.4% of the respondents perceiving improved Chiropractic abilities due to previous research experience. The prevailing practitioner reason for research conducted was that it increased recognition as an EBP, increased development within the profession and validated its claims and theories. An investigation into the student studies found that the majority of the research agendas recommended by the respondents had been undertaken at DUT. Future research into the following areas is encouraged: Neurological testing. Orthopaedic testing. Reduction of posture related disorders. Gross anatomical changes as a result of the Chiropractic manipulation. Range of Motion (ROM) assessment. Muscular testing, motion and/ or static palpation. Gait and posture assessment. The respondents were asked to give recommendations for future Chiropractic research; the majority was willing to contribute a database of shared research ideas. It was anticipated that the sharing of the practitioner ideas with the students would result in more clinically relevant student research being produced. Conclusion: A comparison of the DUT student research agendas and those of Chiropractors in KwaZulu-Natal highlighted an incongruence of purpose between the two. The research agendas recommended by the Chiropractic respondents were recommended for future student uptake. A shared database of student and practitioner research ideas aimed to encourage future student research that is more clinically relevant and in line with local and international research trends.Item The perception, knowledge and utilisation of research and its role in the chiropractic profession as determined by chiropractors attending the World Federation of Chiropractic biennial conference 2013(2015) d'Hotman de Villiers, Jason; O'Connor, LauraBackground The Chiropractic profession is considered a form of complementary and alternative therapy which began as a vitalistic approach to health care. Over the years research has become a main focus of the profession in order to validate its claims for its treatment modalities, with the profession having made advances in producing high quality research (Newell and Cunliffe, 2003). In an era of evidenced based practice medical professionals are required to use research findings to guide their practice therefore their perceptions towards using research are important to ascertain. Although there is some literature on Chiropractors' perception of research most studies focus on specific regional populations. Very few if any studies have assessed perceptions of research from different Chiropractic populations at the same time. The aim of this study was to determine the perception, knowledge and utilisation of research and its role in the Chiropractic profession as determined by Chiropractic delegates attending an international Chiropractic conference. In order to provide information to the profession as to how Chiropractors from varying regions perceive research and to see if the shift seen in other health care professions towards evidence based practice is seen in the chiropractic profession. Method This quantitative, cross sectional, descriptive survey was administered to Chiropractic delegates attending the World Federation of Chiropractic biennial conference 2013 in Durban, South Africa. The questionnaire was compiled by using the available literature and validated by means of a focus group and pilot testing. The questionnaire was administered to the delegates as part of their delegate packs at the conference and was made available electronically via SurveyMonkey© after the conference. Participants were required to give written informed consent prior to partaking in the research. The research protocol was approved by the Durban University of Technology Institutional Research Ethics Committee (REC 26/13). On completion the questionnaire and the signed letter of information and consent were deposited into separate sealed containers at the conference or stored on SurveyMonkey© . When the study closed, data was coded into an excel spread sheet and imported into IBM SPSS version 21 for statistical analysis. Descriptive and inferential statistics were used to analyse the data Results A response rate of 34.48% (n = 140) was obtained. More than half of the respondents were male (52.2%), from the African region (51.1%), in possession of a master's degree in Chiropractic (51.4%), and were involved in professional chiropractic practice (60.7%). The respondents had a favourable perception towards research (51.4%), with almost all respondents perceiving that research was essential to the progression of the Chiropractic profession (97.5%). A more favourable perception of research was found in those who were from Europe as opposed to Africa (p = 0.001) and had an evidence based practice (EBP) philosophical orientation as opposed to a mixer or straight approach (p < 0.001). Overall the respondents displayed an adequate knowledge of research terminology (59.2%), with those from Europe as opposed to Africa (p = 0.001) having improved research knowledge along with those who had an EBP philosophical orientation (p < 0.001) compared to the straights and mixer approaches. In terms of research utilisation the respondents showed a high utilisation of research to improve clinical practice (88.9%), for self-development (90.1%) and to change their approach to conditions, polices and practice in their area of the Chiropractic profession (83%). There was a trend that being from Europe, North America and Australisia resulted in high research utilisation than those from Africa and Asia. The effectiveness of Chiropractic care for various musculoskeletal conditions was seen as the primary research focus area for the profession (95.1%), with 75% of the respondents wanting the profession to move in the direction of science as opposed to a philosophical focus. The respondents perceived research to play an integral role within Chiropractic by promoting its acceptance among other health care professionals (87%) and by third party payers (70%). Conclusion The respondents in this study had a favourable perception, knowledge and utilisation of research and supported the role of research and science in the future of the Chiropractic profession. Future studies should be conducted on more diverse groups of Chiropractors to see if the findings of this study are replicated, as well as investigate the disparity observed between developed and developing countries.Item A study to explore the perceptions that South African chiropractors have regarding the perceived role and impact of research within the profession(2012) Gordon, Julani; Korporaal, Charmaine MariaThe Chiropractic profession has made significant progress with regard to the production of high quality and clinically relevant research in the last 20 years. This correlates with a spike in development within the chiropractic profession as well as its acceptance by the medical fraternity and public. The responsibility for continuing this positive trend is dependent on the chiropractic graduates and practitioners of the future. Therefore, it is important to establish the current perceptions and utilization of research by Chiropractors, so that future research can be built around the needs and requirements of today’s practitioners, thereby ensuring the profession’s continued development and future in health care. The aim of this study was to determine the perceptions that Chiropractors have of research and its relevance / utilization in practice. Method: The study was a quantitative questionnaire based, self administered survey. The sample group included all Chiropractic practitioners currently practising in South Africa (N=515). Results: There was a response rate of 35% (n=174). The results indicated that the perception of research was very positive overall, with the strongest positive response being that research adds credibility to the profession. However, most respondents disagreed with the statement that chiropractors who had done research had an advantage above those who had not. There was a positive, albeit weak correlation between perceptions and utilization of research, indicating that as perceptions increased, so did utilization of research. The area of greatest concern was that even though a high degree of research utilization was reported by chiropractors, research was least likely to be used to change conditions, policies or practices in practice. v Conclusion: The most significant factors associated with positive perceptions and utilization were found to be publishing in a journal and receiving referrals from other health care practitioners. Chiropractors who indicated an interest in doing research again were also very positively linked to utilization. It would seem that even though chiropractors perceive research positively, their implementation into practice has some hurdles that impede the full integration of research into practice. As very few demographic and personal attributes of the South African chiropractor were found to be primarily responsible for low utilization of research in practice, it can be hypothesised that the factors impeding research implementation are most likely environmental in nature.Item The attitudes of chiropractic students towards research at Durban University of Technology(2010) Rieder, Ryan; Talmage, Grant L.; Korporaal, Charmaine MariaBackground: The aim of this study was to determine the attitudes of Chiropractic students towards research at Durban University of Technology (DUT). The Chiropractic profession has made significant progress with regard to the production of high quality and clinically relevant research (Newell and Cunliffe, 2003; Hawk et al, 2008) and the continuation of this research effort will be the responsibility of the graduates that constitute the future profession (Newell and Cunliffe, 2003). Furthermore Cull, Yudkowsky, Schonfeld, Berkowitz and Pan (2003) state that the greatest predictor of this is a positive attitude, therefore it is essential to establish the present attitudes amongst the students. Method: The study was a quantitative questionnaire based, self administered, attitudinal survey. The sample group included all the Chiropractic students registered at DUT (n=185). Results: There was a response rate of 74,59%. The results indicated that on average students thought that the research subjects and courses taught at DUT were not interesting and that they did not adequately prepare them to perform research. The majority of the students felt that the research process was completely vague to them and that they felt insecure about their knowledge of research methodology. It was evident that students thought that DUT staff members placed a great emphasis on research and that they were easy to approach with regards to research. The area of greatest concern was that although students thought that the student researcher relationship was of great importance, they indicated that it was difficult to find a supervisor and they also indicated that inadequate supervision had delayed their research progression. For the most part students thought that research was important and they enjoyed listening to and reading research. However, only slightly positive scores were recorded when students were asked if they wanted to do research in the future, as they felt it was difficult and time consuming. Conclusion: Many factors were significantly associated with positive attitudes towards research at DUT and the strongest correlation between scales was between the importance of research and positive feelings towards research (r=0.713). Most students felt research was important and that it made them more knowledgeable however, if given the choice they would study at an institute where research was not mandatory.