Faculty of Health Sciences
Permanent URI for this communityhttp://ir-dev.dut.ac.za/handle/10321/11
Browse
5 results
Search Results
Item A comparison of the perceptions, use and barriers to evidence based practice by chiropractors and general practitioners in the eThekwini municipality(2018) Koekemoer, Caitlyn; O'Connor, Laura; Padayachy, KeseriBackground: Medicine was the first profession to embrace evidence-based practice (EBP) and has subsequently been the leading profession with its implementation. Many other healthcare professions, including chiropractic, have since embraced the EBP movement. Despite this acceptance, many practitioners report difficulty implementing it into practice. This study aimed to compare the perceptions, use and barriers to EBP by chiropractors and general practitioners (GPs) in private practice within the eThekwini municipality. Method: The study utilised a quantitative paradigm and a cross-sectional descriptive survey design. Once the Durban University of Technology (DUT) Institutional Research Ethics Committee (IREC) approval was obtained, chiropractors (n = 101) and GPs (n = 289) in private practice within the eThekwini municipality were invited to participate. A pre- validated questionnaire and letter of information and consent were administered by electronic mail or hand delivery. The data was analysed using SPSS Version 24.0, (IBM, Armonk NY, U.S.A.) and Statgraphics Centurion (Statgraphics Technologies Inc, Warrenton, Virginia, U.S.A.). A p-value <0.05 was considered as statistically significant. Descriptive and inferential statistics such as cross-tabulations, chi-squared and fisher‘s exact tests were utilised. Results: A 50.5% (n = 51) response rate from the chiropractor respondents and 50.9% (n = 147) with regards to the GP respondents was achieved with respondents having an overall positive perception of EBP, its necessity, use and benefit in patient care. The respondents also displayed a willingness to adopt and improve their use of and skills in EBP. The GP respondents‘ perceptions were more favourable towards the necessity of the application of EBP and the use of literature and research findings in daily practice when compared to those of the chiropractic respondents. The majority of respondents from both professions reported to read and use scientific literature and databases on a regular basis. Most of the GP respondents read scientific literature two to five times per week, while less than half of the chiropractic respondents reported to do the same. The greatest barrier to the use of EBP reported by both professions was insufficient time with significantly more GPs than chiropractors reporting it as their top barrier. Inability of the professional to generalise literature findings to their patient population and inability of the professional to apply research findings to individual patients with unique characteristics were the next main barriers experienced by both professions. Significantly more chiropractic than GP respondents ranked their inability to apply research findings to individual patients with unique characteristics as their top barrier to EBP. Lastly, significantly more chiropractic than GP respondents ranked a lack of collective support among their colleagues in their facility as their greatest barrier to EBP. Conclusion and Recommendations: Both professions were found to have a positive perception of EBP and to be utilising scientific literature and databases regularly. A lack of time was the greatest barrier to the use of EBP, a finding similar to studies conducted with other healthcare professionals. Mechanisms need to be developed to aid practitioners to make time for EBP.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 Chiropractic and public health : a study on the perceptions and attitudes of chiropractors on health promotion and disease prevention in South Africa(2014-04-08) Ford, Timothy William; Korporaal, Charmaine MariaBackground: Considering the quadruple burden of disease and chronic shortages of health care professionals in South Africa, the stance of the chiropractic profession on public health (PH) matters has not been established. Therefore, this study aimed to determine the attitudes and perceptions of chiropractors practicing in South Africa on PH, health promotion (HP) and disease prevention (DP). The objectives were to determine demographic profile, lifestyle practices and attitudes and perceptions of practicing chiropractors in South Africa regarding PH agencies, HP and DP. Methods: An IRB approved quantitative survey (electronic and postal) was used to collect data from a total sample of practicing chiropractors in South Africa (meeting inclusion criteria). Follow up email and telephone calls were made to encourage response from participants. After a 17 - week period, returned questionnaires were collected and data analysed. Results: A response rate of 45% was obtained. Of the participants, 51.7% were female, 60.3% practiced in upper – middle income communities and 66.4% perceived themselves as neuro - musculoskeletal specialists. Over 90% of practitioners regularly counselled patients on postural habits, injury prevention and ergonomic risk reduction. Where as 35.1% agreed to counselling patients on STI / HIV prevention, tobacco cessation and related risks (41.4%), alcohol abuse (53.4%) and cancer prevention (56.9%). Regarding evidence – based practice (EBP) and PH agencies, 39.1% could not identify the statistical significance of the p value and 46% were unable to provide examples to journals they used to inform best practice. Similarly, 59% of the participants could not identify PH agencies to refer to for information on smoking cessation / risks or PH agencies to refer patients on HIV (57%), notifiable diseases (59%) and terminal illnesses (45%). Conclusion: The results suggest that chiropractors from this study were proficient on topics of DP, but were reletively less proficient in regards to PH, HP and EBP. It was recommended that further research be done regarding EBP within the profession and that greater emphasis be placed on topics of HP and PH in chiropractic training programmes.Item The knowledge, perception and utilisation of vitamin and mineral supplements, natural medicines and pharmacological agents as adjuncts to chiropractic practice in South Africa(2009) De Gouveia, Natalie; Wilson, Laura MaieBackground: The aim of this study was to determine the knowledge, perception and utilisation of vitamins and minerals, natural medicines and pharmacological agents as adjuncts to Chiropractic practice in South Africa. Method: This study was a population based cross sectional survey utilising a descriptive, quantitative questionnaire study design. The questionnaire was distributed to all practicing qualified Chiropractors (n=388) and masters Chiropractic students (n=102) in South Africa. Results: The results obtained (30.4% response rate), indicated that the majority of the respondents (62.8%) felt qualified to advise patients on vitamins and mineral supplements and had a positive view of the use of vitamins and minerals as part of Chiropractic patient management (86.6%). The majority of the practitioners were aware that topical substances are part of the scope of practice and males were nearly twice as likely as females to use them. The majority thought biopuncture should be available to Chiropractors (82%) and felt that Chiropractors should challenge the legislation to incorporate biopuncture as part of the scope of practice (77.5%). Most respondents agreed with the statement indicating that NSAIDS should be part of Chiropractic scope of practice and 71% of respondents felt that being able to use NSAIDS in non-emergency situations would enhance patient retention. This study revealed that amongst the student population the majority, if allowed, would consider administering pharmacological agents in practice (55.1%). Conclusion: A correlation exists between the perception, knowledge and utilisation of vitamins and minerals, natural medicines and pharmacological agents in the Chiropractic profession with respect to the demographic data and there is a significant difference in opinion between qualified Chiropractors and Chiropractic masters students regarding perception, knowledge and utilisation of these adjuncts to practice.Item The current role of the chiropractor in the patient-centered approach to stress management(2009) Deonarain, Jitesh; Young, KarinObjectives: The aim of this study was to determine the current role of the Chiropractor in the Patient-Centred Approach to Stress Management. Methods: Chiropractors were contacted telephonically in order to discuss a convenient time in which they are free to receive the questionnaire at their practice. The questionnaire was developed specifically for this particular research project and verified through the use of a focus group and pilot testing. The researcher waited outside the room whilst the Chiropractor completed the questionnaire. The questionnaire was then collected after completion prior the researcher leaving the practice, in order to improve the return of the questionnaires. Results: Seventy-five percent of chiropractors, in the study indicated that they took a psychosocial history which may indicate that they utilised the fundamental biopsychosocial theme of ‘patient-centeredness’. 68.9% of chiropractors who took a psychosocial history indicated that they are equipped with the necessary skills to evaluate psychosocial stressors in patients and 55.6% indicated that their patients responded ‘Very Positively’ to their stress management protocols. All the Chiropractors in the study indicated that they had consulted patients who had associated their main complaint with stress related issues. 38.3% of Chiropractors felt that their patients ‘Often’ associated their main complaint with stress-related issues whilst 35% felt that their patients ‘Very Often’ relate their main complaint with stress-related issues. Muscle spasm (85%) was the most common symptom or sign found or elicited in a patient suffering with chronic stress. Referral was the most common primary method of treatment with 36% of Chiropractors utilising this method in the clinical setting when dealing with a stressed patient. iii Conclusion: Chiropractors in the study indicated that they took a psychosocial history therefore they utilised the fundamental biopsychosocial theme of ‘patientcenteredness’ and that the majority indicated that they are equipped with the necessary skills to evaluate psychosocial stressors in patients and that patients responded positively to their stress management protocols.