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Manschel J, Porthun J, Winkler U, Beuckels JMAT, Martin D. Characteristics, Opportunities, and Challenges of Osteopathy Based on the Perceptions of Osteopaths in Austria: Qualitative Interview Study. JMIR Hum Factors 2024; 11:e45302. [PMID: 38231542 PMCID: PMC10831693 DOI: 10.2196/45302] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/23/2022] [Revised: 11/27/2023] [Accepted: 11/27/2023] [Indexed: 01/18/2024] Open
Abstract
BACKGROUND There are no uniform regulations for the osteopathic profession in Europe. It is subject to country-specific regulations defining who shall be allowed to practice osteopathy and which qualification shall be required. In recent years, legal regulations have been established in several European countries for the profession of osteopathy; however, these are also still pending for Austria. Currently, physiotherapists and physicians with osteopathic training are practicing osteopathy in Austria. OBJECTIVE This study aims to examine the characteristics, challenges, and opportunities of osteopaths in Austria. METHODS Guideline-based interviews with osteopaths (N=10) were conducted. The different research questions were examined using a qualitative content analysis. RESULTS The study provided a differentiated insight into the professional situation of osteopaths in Austria. The most important result was that all interviewees unanimously supported a legal regulation of their profession. However, owing to their different professional self-image-on the one hand, individuals working on a structural basis, and, on the other hand, individuals working on a cranial or biodynamic basis-they were able to imagine a uniform professional regulation only to a limited extent. Additional topics for the interviewed osteopaths in Austria were the quality assurance of training and the urgent need for scientific research. Furthermore, the study also dealt with the influence of the COVID-19 pandemic on daily practice and on education and training in osteopathy. CONCLUSIONS This study is a pioneering study with regard to systematic basic research on osteopathy in Austria. The obtained results and the newly acquired research questions not only have the potential to serve as a basis for further studies but also provide insight into the working and professional situation of osteopaths in Austria for universities, schools, professional associations, politics, and-last but not least-all interested parties. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) RR2-10.2196/15399.
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Affiliation(s)
- Jonas Manschel
- Institute of Integrative Medicine, Department of Medicine, Health Faculty, University Witten/Herdecke, Herdecke, Germany
| | - Jan Porthun
- Norwegian University of Science and Technology, Campus Gjøvik, Gjøvik, Norway
| | | | - Jean Marie A T Beuckels
- Institute of Integrative Medicine, Department of Medicine, Health Faculty, University Witten/Herdecke, Herdecke, Germany
- Department of Osteopathy, Faculty of Health and Social Sciences, Hochschule Fresenius, Munich, Germany
| | - David Martin
- Institute of Integrative Medicine, Department of Medicine, Health Faculty, University Witten/Herdecke, Herdecke, Germany
- Tübingen University Children's Hospital, Tübingen, Germany
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Steel A, Diezel H, Leach M, Bugarcic A. Providing naturopathic care in the community: Perspectives of recent naturopathy graduates in Australia. Complement Ther Clin Pract 2023; 51:101737. [PMID: 36801647 DOI: 10.1016/j.ctcp.2023.101737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/04/2022] [Revised: 01/30/2023] [Accepted: 02/13/2023] [Indexed: 02/17/2023]
Abstract
BACKGROUND AND PURPOSE Naturopathy is a traditional medicine system originating from Europe and naturopathic practitioners provide care to 6.2% of Australians in a 12-month period. Australian naturopathic programs have undertaken a slow transition over the last 20 years from Advanced diploma to Bachelor degree as the minimum level of qualification for entry into the profession. This study aimed to understand and describe the experience of naturopathic graduates completing Bachelor degree and transitioning to provide naturopathic care in the community. MATERIALS AND METHODS Qualitative semi-structured phone interviews were conducted with graduates of Bachelor's degree naturopathy programs, within five years of completing their studies. The data were analysed using Framework analysis methods. RESULTS The analysis identified three related themes: (1) Love for looking after patients, but clinical practice is not easy, (2) Finding a place in the naturopathic profession and in the health system; and (3) Protecting the future of the profession and practice through registration. CONCLUSION Graduates of Australian Bachelor's degree naturopathic programs face challenges as they attempt to find a place within their professional community. By identifying these challenges the profession's leaders may be able to develop initiatives to better support graduates and increase the success of new naturopaths.
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Affiliation(s)
- Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, Faculty of Health, University of Technology Sydney, Ultimo, Australia.
| | - Helene Diezel
- School of Social Science, University of Queensland, Brisbane, Australia
| | - Matthew Leach
- National Centre of Naturopathic Medicine, Southern Cross University, Lismore, Australia
| | - Andrea Bugarcic
- National Centre of Naturopathic Medicine, Southern Cross University, Lismore, Australia
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A C, A S, A G, Pj O. An exploration of the clinical reasoning used by registered osteopaths in their choice of therapeutic approach. INT J OSTEOPATH MED 2022. [DOI: 10.1016/j.ijosm.2022.10.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
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Beliefs and Use of Palpatory Findings in Osteopathic Clinical Practice: A Qualitative Descriptive Study among Italian Osteopaths. Healthcare (Basel) 2022; 10:healthcare10091647. [PMID: 36141259 PMCID: PMC9498689 DOI: 10.3390/healthcare10091647] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 08/24/2022] [Accepted: 08/25/2022] [Indexed: 11/17/2022] Open
Abstract
The Italian government has started the regulatory process of osteopathy to include it among the healthcare professions mentioning terms, such as “perceptual palpation” and “somatic dysfunction” within the professional profile. ‘Palpatory findings’ are one of the multidimensional aspects that can inform osteopathic clinical reasoning. The non-regulated educational system has led to heterogenic professionals working in Italy, thus, the aim of this study was to investigate how Italian experts use palpatory findings in their clinical practice. A total of 12 experts were selected to participate in four virtual focus groups. A qualitative inductive approach with a constructivist paradigm was chosen to describe the results. The themes that emerged were: osteopathic identity; evaluation; osteopathic diagnosis; and sharing with different recipients. Participants agreed on the peculiarity and distinctiveness of osteopathic palpation, but there was some disagreement on the clinical significance of the findings, highlighting a complex multidimensional approach to diagnosis and treatment. The results seem to reflect the history of the profession in Italy, which has evolved quickly, leading professionals to seek new paradigms blending tradition and scientific evidence. The authors suggest further investigation to verify the state of art among osteopaths not involved in research or a broader consensus of the results.
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Skinner D, Esber T, Walkowski S. Evocations of Osteopathy's founder and questions for contemporary osteopathic professional identity: A thematic analysis. INT J OSTEOPATH MED 2022. [DOI: 10.1016/j.ijosm.2022.08.001] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Phillips AR. Professional identity in osteopathy: A scoping review of peer-reviewed primary osteopathic research. INT J OSTEOPATH MED 2022. [DOI: 10.1016/j.ijosm.2022.06.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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Fleischmann M, Vaughan B, Grace S, Stewart A, Hart C, Brew E, Masters G, Smeeton L, Thompson L, Brooks M. The use of visceral techniques in Australian osteopathic practice: A descriptive cross-sectional study. ADVANCES IN INTEGRATIVE MEDICINE 2021. [DOI: 10.1016/j.aimed.2021.07.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Vaughan B, Fleischmann M, Fitzgerald K, Grace S, Orrock P, Steel A. Australian osteopaths as non-medical prescribers: comparison of healthcare practitioner characteristics from a nationally representative survey. Aust J Prim Health 2020; 26:417-423. [PMID: 32883407 DOI: 10.1071/py19248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2019] [Accepted: 06/18/2020] [Indexed: 11/23/2022]
Abstract
The study aimed to compare the characteristics of Australian osteopaths who definitely agree that prescribing scheduled medicines is part of their future scope of practice with those who do not. A secondary analysis of a cross-sectional survey of osteopaths from an Australian practice-based research network was undertaken. Demographic, practice and treatment characteristics were identified using inferential statistics and backward linear regression modelling. Over one-quarter (n=257, 25.9%) of the total participants (n=992) indicated that they 'definitely' agree that osteopaths should seek prescription rights. Adjusted odds ratios (OR) suggested these osteopaths were more likely to engage in medication discussions with patients (OR 1.88), frequently manage migraines (OR 1.68) and seek increased practice rights for referrals to medical specialists (OR 2.61) and diagnostic imaging (OR 2.79). Prescribing as part of the future scope of practice for Australian osteopaths is associated with patient management (medication discussions) and practice characteristics (increased referral rights for specialists and diagnostic imaging) that warrant additional investigation. Understanding of the practice, clinical and patient management characteristics of Australian osteopaths who see prescribing as part of the future scope of practice informs the case for regulatory and health policy changes for prescribing scheduled medicines.
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Affiliation(s)
- Brett Vaughan
- Department of Medical Education, Medical Building, University of Melbourne, Grattan Street, Parkville, Vic. 3010, Australia; and School of Health and Human Sciences, Southern Cross University, Military Road, Lismore, NSW 2480, Australia; and Corresponding author.
| | - Michael Fleischmann
- College of Health and Biomedicine, City Flinders Campus, Victoria University, 301 Flinders Lane, Melbourne, Vic. 3000, Australia
| | - Kylie Fitzgerald
- School of Health and Biomedical Sciences, Bundoora Campus, RMIT University, Plenty Road, Bundoora, Vic. 3083, Australia
| | - Sandra Grace
- School of Health and Human Sciences, Southern Cross University, Military Road, Lismore, NSW 2480, Australia
| | - Paul Orrock
- School of Health and Human Sciences, Southern Cross University, Military Road, Lismore, NSW 2480, Australia
| | - Amie Steel
- Australian Research Centre in Complementary and Integrative Medicine, University of Technology Sydney, 15 Broadway, Ultimo, NSW 2007, Australia
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"If you don't use or understand visceral osteopathy you're not a real osteopath": Professional identity in Australian osteopathy through the lens of a single traditional technique. Explore (NY) 2020; 17:535-540. [PMID: 32736952 DOI: 10.1016/j.explore.2020.07.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2020] [Revised: 07/06/2020] [Accepted: 07/07/2020] [Indexed: 11/20/2022]
Abstract
BACKGROUND/CONTEXT Manual therapists utilise a range of techniques in the clinical practice to manage predominantly musculoskeletal complaints. There are, however, a number of practitioners who utilise techniques that are directed towards the bodies' visceral structures. Osteopaths are one such professional group that utilise these techniques in their practice. Like many health professions, the identity of the osteopathy profession is evolving, and the techniques osteopaths use form part of this identity. OBJECTIVE Explore free text responses to a questionnaire about the use of techniques directed towards the viscera. METHODS/DESIGN Australian osteopaths who were part of a practice-based research network, were invited to complete a survey about their use of techniques applied to the viscera. Participants were also invited to provide free-text responses to a number of items related to the use of these techniques. Free-text responses were thematically analysed. PARTICIPANTS 137 participants completed the survey. RESULTS Three themes were identified: being an osteopath; applying visceral techniques in practice - evidence conflicts with practice; and, inadequate education in visceral techniques. CONCLUSIONS Participant responses resonated with the internal (own world views, beliefs) and external (external perceptions of the profession, education) influences that underpin the theory of a professions' identity. Our work demonstrates that the Australian osteopathy profession exhibits an identity similar to other manual therapies - the profession is somewhat fragmented in its views about its practice. Additional research is required to explore whether other manual therapy techniques used by osteopaths elicit similar responses and how those external to the profession perceive it.
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A study of the factors impacting on workforce distribution of Australian osteopaths: The perspectives of osteopathic students, academics and clinicians. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.02.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
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Moving towards a contemporary chiropractic professional identity. Complement Ther Clin Pract 2020; 39:101105. [PMID: 32379646 DOI: 10.1016/j.ctcp.2020.101105] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2020] [Accepted: 01/20/2020] [Indexed: 12/18/2022]
Abstract
Since the inception of the chiropractic profession, debate has continued on differing practice objectives and philosophical approaches to patient care. While the political and academic leaders of the profession continue to dominate the discourse, little is known on the perspectives of the everyday practising chiropractor on their professional identity. In this paper, professional identity within the profession of chiropractic was evaluated using a systematised search strategy of the literature from the year 2000 through to May 2019. Initially 562 articles were sourced, of which 24 met the criteria for review. The review confirmed three previously stated professional identity subgroups; two polarised approaches and a centrist or mixed view. The musculoskeletal biomedical approach is in contrast to the vertebral subluxation vitalistic practice approach. Whilst these three main chiropractic identity subtypes exist, within the literature the terminology used to describe them differs. Research aimed at categorising the chiropractic profession identity into exclusive subtypes found that at least 20% of chiropractors have an exclusive vertebral subluxation focus. However, deeper exploration of the literature shows that vertebral subluxation is an important practice consideration for up to 70% of chiropractors. Patient care with a musculoskeletal spine focus is dominant in clinical practice. This review found that practising chiropractors consider themselves to be primary care or primary contact practitioners with a broad scope of practice across a number of patient groups not limited to musculoskeletal management. Across the research, there is a marked difference in the categories of practice objectives evaluated, and future research could examine the relatedness of these. Additionally, future research could explore the professional identity construct over time and within different practice contexts to help facilitate the progression of the profession.
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Porthun J, Manschel J. Characteristics, Opportunities, and Challenges of Osteopathy (COCO) in the Perceptions of Osteopaths in Germany, Austria, and Switzerland: Protocol for a Comprehensive Mixed Methods Study. JMIR Res Protoc 2019; 8:e15399. [PMID: 31850852 PMCID: PMC6939278 DOI: 10.2196/15399] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2019] [Revised: 08/29/2019] [Accepted: 09/30/2019] [Indexed: 11/13/2022] Open
Abstract
Background Currently, the importance of osteopathy within the health care system is controversial. The training structures and the acknowledgment of the occupational profile strongly differ in the German-speaking territory. Objective This study aims to examine the characteristics of the osteopathic profession as well as the possibilities and challenges for osteopaths in Germany, Austria, and Switzerland. Methods This study adopted a mixed methods design. The research topic will be examined based on qualitative and quantitative partial studies that will be conducted in parallel as well as sequentially. By applying different research methods and sample testing and by using standardized, validated measurement methods, we expect to be able to gain new insights into the work area of osteopathy. Results In November 2018, we started the research and data collection. Currently, we are conducting the first two partial studies. The planned duration of each of the partial study is 6-9 months. The project is scheduled to be completed in 2021. Conclusions This study will examine how osteopaths define themselves in comparison with professionals from other occupational profiles and how they describe the characteristics of their work. The identification of central issues is expected to help clarify the issues and define the profession. As such, the results might contribute to the conservation and improvement of the quality of osteopathic treatment. International Registered Report Identifier (IRRID) PRR1-10.2196/15399
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Affiliation(s)
- Jan Porthun
- Department of Health Sciences Gjøvik, Norwegian University of Science and Technology, Gjøvik, Norway
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Leach MJ, Sundberg T, Fryer G, Austin P, Thomson OP, Adams J. An investigation of Australian osteopaths' attitudes, skills and utilisation of evidence-based practice: a national cross-sectional survey. BMC Health Serv Res 2019; 19:498. [PMID: 31315615 PMCID: PMC6637614 DOI: 10.1186/s12913-019-4329-1] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/19/2019] [Accepted: 07/08/2019] [Indexed: 12/19/2022] Open
Abstract
Background Osteopaths are an integral member of the health care team, playing a pivotal role in the provision of care for patients with musculoskeletal disorders. Osteopaths, like other health care providers, are under increasing pressure to deliver evidence-based health care and to improve patient outcomes. However, the extent to which osteopaths engage in evidence-based practice (EBP), particularly in Australia, is not well understood. This study therefore set out to investigate the attitudes, skills and use of EBP, and perceived barriers and enablers of EBP uptake, among osteopaths practicing in Australia. Methods National cross-sectional survey of Australian registered osteopaths. Eligible participants were invited by email and other digital media recruitment strategies to complete the online Evidence-Based Practice Attitude and Utilisation Survey (EBASE). Results A total of 332 osteopaths completed the survey. The demographic characteristics of respondents were generally consistent with the characteristics of the Australian osteopathy workforce. The respondents were mostly favourable of EBP, with the majority agreeing or strongly agreeing that EBP assists in making decisions about patient care (86.7%) and improves the quality of patient care (75.6%). While most respondents (88.3%) had some training in EBP, most reported a moderate level of perceived skill in EBP. The majority of respondents engaged infrequently (0–5 times) in EBP activities within the last month, and most indicated that a very small or small proportion of their clinical practice was based on clinical research evidence. Leading barriers to the uptake of EBP were lack of time and lack of clinical evidence in osteopathy. Key enablers of EBP uptake were access to the internet and online databases at work, and access to full-text articles and EBP education materials. Conclusions Osteopaths participating in the survey were largely supportive of evidence-based practice, yet engaged infrequently in EBP activities. An important next step in this research is to identify suitable strategies that effectively improve EBP uptake in osteopathy, and perchance, improve patient outcomes.
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Affiliation(s)
- Matthew J Leach
- Department of Rural Health, University of South Australia, Adelaide, Australia.,Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Tobias Sundberg
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.,Musculoskeletal and Sports Injury Epidemiology Center (MUSIC), Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Gary Fryer
- College of Health & Biomedicine, Victoria University, Melbourne, Victoria, Australia.
| | - Philip Austin
- Department of Pain Management, Greenwich Hospital, Sydney, Australia
| | - Oliver P Thomson
- University College of Osteopathy, London, United Kingdom.,Clinical-based Human Research Department, Centre for Osteopathic Medicine Collaboration (COME), Pescara, Italy
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
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