Perceptions, expectations and experiences of first time chiropractic patients when consulting chiropractic students at a teaching clinic in KwaZulu-Natal

Abstract

The focus of the chiropractic profession is to diagnose, treat and prevent mechanical disorders which affect the neuromusculoskeletal system of the body. Chiropractic is a young profession in South Africa as law only recognized chiropractors as recently as 1971. As a result, perceptions of chiropractic are continually evolving as it gains popularity among the public. Despite its growth to date, further expansion of the profession may be limited due to its isolation from the public health care system of South Africa.

This study aimed to determine the demographics, perceptions, expectations and experiences of first time chiropractic patients who consulted chiropractic students at a teaching clinic in KwaZulu-Natal. This information may allow identification of requirements for improved clinical outcomes of first time chiropractic patients and clinical practice of chiropractors and the chiropractic profession.

This qualitative study utilized an exploratory and descriptive design. This methodology was chosen for its potential to reveal a deeper understanding of the fundamentals of chiropractic. Data collection involved semi-structured interviews with fourteen first time chiropractic patients who presented to the Durban University of Technology (DUT) Chiropractic Day Clinic (CDC). Interviews were voice recorded, transcribed verbatim and analysed which resulted in eight themes with numerous subthemes. These were explored and demographic characteristics of participants were determined to fulfil the objectives of the study.

Eight participants were male and six were female. Most were aged in their thirties, forties or fifties. With regards to population groups, six participants were Black/African, three were Indian, three were Coloured and two were White. Half the participants had medical aid and most were professionals, technicians and associate professionals and services and sales workers.

The understanding of chiropractic and chiropractic care theme revealed a limited awareness and understanding of chiropractic, perceptions of the chiropractic scope of practice and beliefs regarding chiropractic care for special population groups. The care-seeking influential factors theme indicated that the reasons chiropractic care was sought were: soreness, trusted suggestions and unsuitable alternative care options.

The experience anticipations theme showed that some participants had indistinct ideas prior to their experiences while others had conceived expectations for the chiropractic care. The consultation outcomes theme indicated expectations for improvement in presenting complaints as well as occurrence of adverse reactions. The origins of beliefs theme revealed that perceptions and expectations of chiropractic were formed from accessible information as well as the first time chiropractic consultation experience.

Professional and unprofessional aspects of the DUT CDC environment were discussed in the first impressions theme. The chiropractic care theme explored experiences of the thorough and detailed examination, feelings of fear and apprehension and trust and comfort, patient centered care, effectiveness of the treatment and pain and adverse effects. The last theme, experience reflections, demonstrates the extent to which expectations were met, aspects of the experience which could be improved and desires to return to and recommend the DUT CDC to others.