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Zegarra-Parodi R, D’Alessandro G, Baroni F, Swidrovich J, Mehl-Madrona L, Gordon T, Ciullo L, Castel E, Lunghi C. Epistemological Flexibility in Person-Centered Care: The Cynefin Framework for (Re)Integrating Indigenous Body Representations in Manual Therapy. Healthcare (Basel) 2024; 12:1149. [PMID: 38891224 PMCID: PMC11171789 DOI: 10.3390/healthcare12111149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/31/2024] [Accepted: 06/02/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Chiropractic, osteopathy, and physiotherapy (COP) professionals regulated outside the United States traditionally incorporate hands-on procedures aligned with their historical principles to guide patient care. However, some authors in COP research advocate a pan-professional, evidence-informed, patient-centered approach to musculoskeletal care, emphasizing hands-off management of patients through education and exercise therapy. The extent to which non-Western sociocultural beliefs about body representations in health and disease, including Indigenous beliefs, could influence the patient-practitioner dyad and affect the interpretation of pillars of evidence-informed practice, such as patient-centered care and patient expectations, remains unknown. METHODS our perspective paper combines the best available evidence with expert insights and unique viewpoints to address gaps in the scientific literature and inform an interdisciplinary readership. RESULTS A COP pan-professional approach tends to marginalize approaches, such as prevention-oriented clinical scenarios traditionally advocated by osteopathic practitioners for patients with non-Western sociocultural health assumptions. The Cynefin framework was introduced as a decision-making tool to aid clinicians in managing complex clinical scenarios and promoting evidence-informed, patient-centered, and culturally sensitive care. CONCLUSION Epistemological flexibility is historically rooted in osteopathic care, due to his Indigenous roots. It is imperative to reintroduce conceptual and operative clinical frameworks that better address contemporary health needs, promote inclusion and equality in healthcare, and enhance the quality of manual therapy services beyond COP's Western-centered perspective.
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Affiliation(s)
| | - Giandomenico D’Alessandro
- Clinical-Based Human Research Department, Foundation Centre for Osteopathic Medicine (COME) Collaboration, 65121 Pescara, Italy;
- Research Department, A.T. Still Academy Italia (ATSAI), 70124 Bari, Italy
| | | | - Jaris Swidrovich
- Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, ON M5S 3M2, Canada;
| | | | - Travis Gordon
- College of Osteopathic Medicine, Michigan State University, East Lansing, MI 48824, USA;
| | - Luigi Ciullo
- Istituto Europeo per la Medicina Osteopatica (IEMO), 16122 Genova, Italy;
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Gillan R, Bachtel G, Webber K, Ezzair Y, Myers NE, Bishayee A. Osteopathic manipulative treatment for chronic inflammatory diseases. J Evid Based Med 2024; 17:172-186. [PMID: 38488211 DOI: 10.1111/jebm.12590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/16/2023] [Accepted: 02/25/2024] [Indexed: 04/02/2024]
Abstract
Chronic inflammatory diseases (CIDs) are debilitating and potentially lethal illnesses that affect a large proportion of the global population. Osteopathic manipulative treatment (OMT) is a manual therapy technique developed and performed by osteopathic physicians that facilitates the body's innate healing processes. Therefore, OMT may prove a beneficial anti-inflammatory modality useful in the management and treatment of CIDs. This work aims to objectively evaluate the therapeutic benefits of OMT in patients with various CIDs. In this review, a structured literature search was performed. The included studies involving asthma, chronic obstructive pulmonary disease, irritable bowel syndrome, ankylosing spondylitis, and peripheral arterial disease were selected for this work. Various OMT modalities, including lymphatic, still, counterstain, and muscle energy techniques, were utilized. Control treatments included sham techniques, routine care, or no treatment. OMT utilization led to variable patient outcomes in individuals with pathologies linked to CID.
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Affiliation(s)
- Ross Gillan
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Gabrielle Bachtel
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Kassidy Webber
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Yasmine Ezzair
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Nicole E Myers
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
| | - Anupam Bishayee
- College of Osteopathic Medicine, Lake Erie College of Osteopathic Medicine, Bradenton, Florida, USA
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Leach MJ, Agnew T. Evidence implementation in Australian manual therapy practice: A cross-sectional study. J Bodyw Mov Ther 2023; 36:109-116. [PMID: 37949546 DOI: 10.1016/j.jbmt.2023.05.007] [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: 02/02/2023] [Accepted: 05/01/2023] [Indexed: 11/12/2023]
Abstract
BACKGROUND Few studies have explored the determinants of evidence implementation in complementary manual therapy professions. Exploring the factors that impede or enable evidence implementation in complementary manual therapy professions is critical to determining the most appropriate strategies to optimise this practice, and enhance the quality of care. METHODS The study used a cross-sectional study design to examine Australian complementary medicine manual therapists' attitudes, skills, training, use, barriers and enablers to evidence implementation. Eligible therapists were invited to self-administer the 84-item Evidence-Based practice Attitude and utilization Survey online. RESULTS The survey was completed by 294 manual therapists (77% female; 65% aged ≥50 years). Participants were mostly supportive of, and reported a moderate to moderate-high level of skill in evidence implementation. However, the level of engagement in evidence implementation was low. The leading barriers to evidence implementation were lack of time, and lack of clinical evidence. While few participants reported skill-level as a barrier, most indicated a desire to develop the skills necessary to improve their engagement in evidence implementation. Participants also supported a range of other enabling strategies to foster evidence implementation in their practice, with most of these strategies targeting access to evidence. CONCLUSIONS Although participants reported few barriers to evidence implementation, there was a low level of engagement in this activity. The barriers to evidence implementation therefore warrant further exploration. This ongoing work will help better understand how to optimise evidence implementation in complementary manual therapy practice, and help drive improvements in patient care.
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Affiliation(s)
- Matthew J Leach
- Faculty of Health, Southern Cross University, Military Road, Lismore, NSW, 2480, Australia.
| | - Tamara Agnew
- Faculty of Health, Southern Cross University, Military Road, Lismore, NSW, 2480, Australia.
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Myhrvold BL, Axén I, Leach MJ, Sundberg T, Gausel AM. Investigating attitudes, skills, and use of evidence-based practice among Norwegian chiropractors; a national cross-sectional study. BMC Health Serv Res 2023; 23:385. [PMID: 37081471 PMCID: PMC10116754 DOI: 10.1186/s12913-023-09354-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/22/2022] [Accepted: 03/30/2023] [Indexed: 04/22/2023] Open
Abstract
BACKGROUND Evidence-based practice (EBP) is essential in improving the quality of healthcare and of importance for all health care personnel. No study in Norway has investigated attitudes, skills and use related to EBP among chiropractors. The aim of this study was to describe Norwegian chiropractors' attitudes, skills, and use of EBP, as well as the barriers and facilitators to their use of EBP. METHODS A national cross-sectional survey, the online version of the Evidence Based practice Attitudes & Utilisation SurvEy (EBASE), was sent by email to 770 Norwegian practicing chiropractors, all members of the Norwegian Chiropractic Association. Three EBASE sub-scores were generated (Attitudes, Skills and Use), and the demographic characteristics of the sample were reported. Linear regression analyses were conducted to examine the association between responses of the three sub-scores and demographic characteristics. Information on main barriers and facilitators of EBP was collected and described. RESULTS A total of 312 (41%) chiropractors responded to the survey, and 95% agreed that EBP is necessary for chiropractic practice. While overall use of EBP activities was low participants were interested in learning and improving their skills to incorporate EBP into practice. Chiropractors' attitudes, skills, and use of EBP were positively associated with being female and having spent more than one hour per week on research, but negatively associated with having practiced more than 10 years. Main barriers of EBP were lack of skills to critically evaluate, interpret, and apply research findings to practice. Main facilitators of EBP included access to the internet and free online databases in the workplace. CONCLUSION Although chiropractors in Norway reported positive attitudes and moderate skills in EBP, their use of EBP activities was limited. The main barriers and facilitators to EBP were primarily related to perceived skills deficits, whilst enablers of EBP were mostly related to infrastructure requirements.
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Affiliation(s)
- Birgitte Lawaetz Myhrvold
- Department of Interdisciplinary Health Sciences, Institute of Health and Society, University of Oslo, P.O. Box 1089, Blindern, Oslo, 0317, Norway.
- Et Liv I Bevegelse (ELiB), The Norwegian Chiropractic Research Foundation, Oslo, Norway.
| | - Iben Axén
- Et Liv I Bevegelse (ELiB), The Norwegian Chiropractic Research Foundation, Oslo, Norway
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Nobels väg 13, 171 77, Stockholm, Sweden
| | - Matthew J Leach
- National Centre for Naturopathic Medicine, Southern Cross University, Military Road, East Lismore, NSW, Sydney, 2480, Australia
| | - Tobias Sundberg
- Musculoskeletal & Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Box 5605, Stockholm, 114 86, SE, Sweden
| | - Anne Marie Gausel
- Et Liv I Bevegelse (ELiB), The Norwegian Chiropractic Research Foundation, Oslo, Norway
- Department for Caring and Ethics, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- Department of Obstetrics and Gynecology, Stavanger University Hospital, Stavanger, Norway
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What's wrong with osteopathy? INT J OSTEOPATH MED 2023. [DOI: 10.1016/j.ijosm.2023.100659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
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Sundberg T, Leach MJ, Lilje S, Thomson OP, Fryer G, Palmgren PJ, Adams J, Skillgate E. Attitudes, skills and implementation of evidence-based practice: a national cross-sectional survey of licensed naprapaths in Sweden. Chiropr Man Therap 2023; 31:3. [PMID: 36670483 PMCID: PMC9863153 DOI: 10.1186/s12998-023-00473-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Accepted: 01/02/2023] [Indexed: 01/22/2023] Open
Abstract
BACKGROUND Evidence-based practice (EBP) is fundamental to the delivery of high-quality, safe and effective health care. Naprapaths, manual therapy providers that specialize in the treatment of musculoskeletal pain and dysfunction, became a Swedish licensed health profession in 1994. This study investigated the attitudes, skills and implementation of EBP among licensed naprapaths in Sweden. METHODS Licensed naprapaths (n = 950) of Svenska Naprapatförbundet (the Swedish Naprapathy Association) were invited by email to take part in this cross-sectional anonymous online study using the Evidence-Based Practice Attitude and Utilisation Survey in February 2019. RESULTS Fourteen percent (137/950) of invited naprapaths completed the survey. There was an approximately equal gender divide among responders; most were in the mid-career age range, practiced in city areas, and had a university or college certificate/diploma as their highest qualification. The majority of naprapaths agreed or strongly agreed that EBP was necessary in the practice of naprapathy, assisted them in making care decisions, and improved the quality of patient care. Naprapaths' self-reported skills in EBP were mostly in the moderate to moderate-high range. The majority of participating naprapaths reported infrequent implementation of EBP. Perceived minor or moderate barriers to EBP uptake included a lack of colleague support for EBP and a lack of relevant resources. Access to the internet and free online databases were reported as very useful enablers to improving EBP uptake. CONCLUSIONS The licensed naprapaths participating in this survey reported positive attitudes toward EBP, moderate levels of EBP skills, and infrequent implementation of EBP.
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Affiliation(s)
- Tobias Sundberg
- Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden.
| | - Matthew J. Leach
- grid.1031.30000000121532610National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW Australia ,grid.117476.20000 0004 1936 7611Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Stina Lilje
- grid.4714.60000 0004 1937 0626Musculoskeletal and Sports Injury Epidemiology Center, Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Oliver P. Thomson
- grid.468695.00000 0004 0395 028XResearch Centre, University College of Osteopathy, London, UK
| | - Gary Fryer
- grid.1019.90000 0001 0396 9544College of Health and Biomedicine, Victoria University, Melbourne, Vic Australia
| | - Per J. Palmgren
- grid.4714.60000 0004 1937 0626Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | - Jon Adams
- grid.117476.20000 0004 1936 7611Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW Australia
| | - Eva Skillgate
- grid.445308.e0000 0004 0460 3941Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Science, Sophiahemmet University, Stockholm, Sweden ,grid.4714.60000 0004 1937 0626Musculoskeletal and Sports Injury Epidemiology Center, Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
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Leach MJ, Aucoin M, Cooley K. Canadian Naturopathic Doctor Engagement, Preparedness, and Perceptions of Evidence-Based Practice: A National Cross-Sectional Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2022; 28:955-964. [PMID: 36083287 DOI: 10.1089/jicm.2022.0637] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
Background: Despite the reported benefits of evidence-based practice (EBP), there are concerns that some practitioners, including naturopathic doctors (NDs), may be cautious about its use. The objective of this study was to explore Canadian ND perceptions, preparedness, and engagement in EBP, and the barriers and enablers to EBP uptake. Methods: The study was a national cross-sectional survey. NDs practicing in Canada were invited to complete the validated 84-item Evidence-Based Practice Attitudes and Utilization Survey between February and May 2020. Results: A total of 252 Canadian NDs were recruited. Participant attitudes toward EBP were predominantly positive, with three-quarters of participants indicating that >50% of their practice was informed by clinical research evidence. One-half of participants self-reported a medium-high to high level of skill across most EBP-related activities. Notable barriers to EBP uptake were lack of clinical evidence in naturopathy, and lack of time. Access to the internet and online databases were identified as useful enablers to improving EBP engagement. Conclusions: By shedding light on Canadian ND engagement with, preparedness for, and perceptions of EBP, the findings will help guide the development of strategies to support EBP uptake in NDs with the expectation of improving quality of care.
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Affiliation(s)
- Matthew J Leach
- National Centre for Naturopathic Medicine, Faculty of Health, Southern Cross University, Lismore, Australia
| | - Monique Aucoin
- Canadian College of Naturopathic Medicine, Toronto, Canada
| | - Kieran Cooley
- Canadian College of Naturopathic Medicine, Toronto, Canada
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Leach MJ, Veziari Y. Enablers and Barriers to Evidence Implementation in Complementary Medicine: A Systematic Review. Integr Med Res 2022; 11:100899. [DOI: 10.1016/j.imr.2022.100899] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2022] [Revised: 10/27/2022] [Accepted: 10/30/2022] [Indexed: 11/05/2022] Open
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Leach MJ, Foley H. Evidence implementation among complementary medicine practitioners: a meta-summary. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2022; 19:499-511. [PMID: 35998915 DOI: 10.1515/jcim-2022-0234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/17/2022] [Accepted: 07/17/2022] [Indexed: 06/15/2023]
Abstract
OBJECTIVES To explore the factors impacting evidence implementation in complementary medicine (CM) practice. CONTENT MEDLINE and CINAHL were systematically searched for cross-sectional studies examining evidence implementation among CM practitioners. Qualitative data from eligible studies were collated and analysed using a meta-summary approach. Data were coded according to the five domains of the Consolidated Framework for Implementation Research (CFIR), and translated into barriers and enablers. SUMMARY Qualitative data were available for 614 participants (from 16 disciplines) across 14 studies. Coding identified 34 themes, with most themes aligning with the Inner Setting (11 themes) and Characteristics of the Intervention (10 themes) domains of the CFIR. The most commonly referenced barriers to evidence implementation were: 'Lack of supportive resources' (Effect size [ES]=33.3%), 'Research misalignment with profession and practice' (ES=14.5%) and 'Lack of access to knowledge and information' (ES=10.5%). The most common enablers were: 'Recognition of a need for change' (ES=8.2%) and 'Perceived adaptability of EBP to the profession' (ES=7.8%). OUTLOOK This research offers new insights into the challenges and opportunities to implementing evidence-based practices in the field of CM. The findings underline the complexity of the phenomenon, and the need for a nuanced, multi-faceted and multi-stakeholder approach to improving evidence implementation in CM.
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Affiliation(s)
- Matthew J Leach
- National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW, Australia
| | - Hope Foley
- National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW, Australia
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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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The utilisation and attitudes to patient reported outcome measures by Australian osteopaths: A cross sectional study. INT J OSTEOPATH MED 2022. [DOI: 10.1016/j.ijosm.2022.07.003] [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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Li C, Li L, Wang Z. Knowledge, attitude and behaviour to evidence-based practice among psychiatric nurses: A cross-sectional survey. Int J Nurs Sci 2022; 9:343-349. [PMID: 35891916 PMCID: PMC9305010 DOI: 10.1016/j.ijnss.2022.06.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2021] [Revised: 06/04/2022] [Accepted: 06/14/2022] [Indexed: 11/16/2022] Open
Abstract
Objective Methods Results Conclusion
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Affiliation(s)
- Ce Li
- School of Nursing, Peking University, Beijing, China
| | - Liyu Li
- Peking University First Hospital, Peking University, Beijing, China
| | - Zhiwen Wang
- School of Nursing, Peking University, Beijing, China
- Corresponding author.
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Santiago RJ, Nunes A, Esteves JE, Cerritelli F, Verbeeck J, Lopes S, Paquete M, van Dun P. The Portuguese Osteopathic Practitioners Estimates and RAtes (OPERA): A cross-sectional survey. INT J OSTEOPATH MED 2022. [DOI: 10.1016/j.ijosm.2022.04.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Veziari Y, Kumar S, Leach MJ. An exploration of barriers and enablers to the conduct and application of research among complementary and alternative medicine stakeholders in Australia and New Zealand: A qualitative descriptive study. PLoS One 2022; 17:e0264221. [PMID: 35180276 PMCID: PMC8856519 DOI: 10.1371/journal.pone.0264221] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2021] [Accepted: 02/06/2022] [Indexed: 01/12/2023] Open
Abstract
BACKGROUND Most studies examining complementary and alternative medicine (CAM) stakeholder engagement with evidence-based practice have relied on quantitative research methods, which often fail to capture the nuances of this phenomena. Using qualitative methods, this study aimed to explore the experiences of CAM stakeholders regarding the barriers and enablers to the conduct and application of research. METHODS This research was guided by a qualitative descriptive framework. CAM practitioners and researchers of multiple CAM disciplines from across Australia and New Zealand were invited to share their personal perspectives of the study phenomena. Semi-structured interviews were conducted via Zoom, which were audio-recorded and transcribed verbatim. Rigour strategies were applied to ensure the credibility of results. The transcript was analysed using thematic analysis. RESULTS CAM stakeholders identified an array of barriers and enablers to the conduct and application of research within their disciplines. The barriers and enablers that emerged were found to be inter-connected with two similar constructs: capacity and culture. Captured within the construct of capacity were five themes-lack of resources, inadequate governance/leadership, lack of competency, bias directed from outside and within CAM, and lack of time for research. Within the construct of culture were two themes-intrinsic perceptions in CAM, and lack of communication within and outside CAM. CONCLUSIONS Promoting evidence-based practice and engaging with research in CAM continues to face challenges. This study, for the first time, has highlighted the multitude of interlinked barriers that confront CAM stakeholders when engaging with research. These findings highlight the need for a concerted and targeted approach to tackle these challenges.
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Affiliation(s)
- Yasamin Veziari
- UniSA Allied Health & Human Performance, University of South Australia, North Terrace, Adelaide, South Australia, Australia
| | - Saravana Kumar
- UniSA Allied Health & Human Performance, University of South Australia, North Terrace, Adelaide, South Australia, Australia
| | - Matthew J. Leach
- Southern Cross University, National Centre for Naturopathic Medicine, East Lismore, New South Wales, Australia
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Leach MJ. Implementation science in New Zealand naturopathic practice: a cross-sectional study. JOURNAL OF COMPLEMENTARY & INTEGRATIVE MEDICINE 2022; 19:781-790. [PMID: 35092655 DOI: 10.1515/jcim-2021-0508] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/17/2022] [Indexed: 11/15/2022]
Abstract
OBJECTIVES Understanding and addressing the barriers to evidence-based practice (EBP) falls within the realm of implementation science. To date, disciplines such as naturopathy have paid little attention to implementation science, meaning the obstacles to delivering best practice care have largely been ignored. This study addresses this knowledge gap by examining the determinants of evidence implementation in New Zealand naturopathic practice. METHODS This cross-sectional study was open to all New Zealand naturopaths who had Internet access, and were fluent in the English language. Participants were invited to complete the 84-item Evidence-Based practice Attitude and utilization Survey (EBASE) online between February and July 2020. RESULTS The survey was completed in full by 104 naturopaths (86% female; 55% aged 40-59 years). While attitudes toward EBP were generally favourable, engagement in EBP activities was reported at a moderate-low level. Factors potentially contributing to the modest uptake of EBP were the moderate level of self-reported EBP-related skill, lack of clinical evidence in naturopathy and lack of time. Enablers of EBP uptake that were supported by the majority of participants were access to the Internet, online databases, EBP education materials, and full-text journal articles. CONCLUSIONS This study has provided much-needed insight into the level of EBP engagement among New Zealand naturopaths, as well as the various factors impacting evidence implementation. Attitude did not pose a major barrier to evidence implementation; rather, the barriers were largely structural, cognitive and cultural. This suggests that the barriers to EBP uptake in naturopathy are not unsurmountable.
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Affiliation(s)
- Matthew J Leach
- National Centre for Naturopathic Medicine, Southern Cross University, Military Road, Lismore, NSW 2480, Australia
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Cerritelli F, Iacopini A, Galli M, Thomson OP, Sundberg T, Leach MJ, Adams J. Evidence-based practice among Italian osteopaths: a national cross-sectional survey. BMC Complement Med Ther 2021; 21:252. [PMID: 34620142 PMCID: PMC8496002 DOI: 10.1186/s12906-021-03430-y] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 09/30/2021] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND While evidence-based practice (EBP) is widely accepted across healthcare professions, research investigating its implementation in manual therapy professions such as osteopathy is limited. The primary aim of this study was to investigate Italian osteopaths' attitudes, skills, and use of EBP. A secondary purpose was to understand the obstacles and enablers to EBP adoption in the Italian osteopathic context. METHODS A cross-sectional national survey was conducted (April to June 2020) among a sample of Italian osteopaths. Eligible participants were invited to complete the Italian-translated Evidence-Based practice Attitude and Utilization Survey (EBASE) anonymously online using various recruitment strategies, including email and social media campaigns. In addition to the three EBASE sub-scores (attitudes, skills and use), the demographic characteristics of the sample were considered. RESULTS A total of 473 osteopaths responded to the survey. The sample appeared to represent the Italian osteopathic profession. The majority of participants had a favorable attitude toward EBP. Eighty-eight percent of respondents agreed that EBP was necessary for osteopathy practice and that scientific literature and research findings were beneficial to their clinical scenario (95%). Perceived skill levels in EBP were rated as moderate, with the lowest scores for items relating to clinical research and systematic review conduct. Apart from reading/reviewing scientific literature and using online search engines to locate relevant research papers, participant engagement in all other EBP-related activities was generally low. Clinical practice was perceived to be based on a very small proportion of clinical research evidence. The primary obstacles to EBP implementation were a dearth of clinical evidence in osteopathy, and poor skills in applying research findings. The primary enablers of EBP adoption were access to full-text articles, internet connectivity at work, and access to online databases. CONCLUSIONS Italian osteopaths were largely supportive of evidence-based practice but lacked basic skills in EBP and rarely engaged in EBP activities. The updating of osteopathic training curriculum and professional formal regulation in Italy could provide a suitable framework to improve EBP skills and use.
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Affiliation(s)
- Francesco Cerritelli
- Clinical-based Human Research Department, Foundation COME Collaboration, Pescara, Italy.
| | - Alessio Iacopini
- Clinical-based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Matteo Galli
- Clinical-based Human Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Oliver P Thomson
- Clinical-based Human Research Department, Foundation COME Collaboration, Pescara, Italy.,University College of Osteopathy, London, UK
| | - 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), Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden.,Unit of Intervention and Implementation Research on Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Matthew J Leach
- Australian Research Centre in Complementary and Integrative Medicine (ARCCIM), Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia.,National Centre for Naturopathic Medicine, Southern Cross University, Lismore, NSW, Australia
| | - 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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Morin C, Gaboury I. Osteopathic empirical research: a bibliometric analysis from 1966 to 2018. BMC Complement Med Ther 2021; 21:196. [PMID: 34233684 PMCID: PMC8265137 DOI: 10.1186/s12906-021-03366-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2020] [Accepted: 06/24/2021] [Indexed: 12/12/2022] Open
Abstract
Background Despite the increasing use of osteopathy, a manipulative complementary and alternative medicine therapy, in the general population, its efficacy continues to be debated. In this era of evidence-based practice, no studies have previously reviewed the scientific literature in the field to identify published knowledge, trends and gaps in empirical research. The aims of this bibliometric analysis are to describe characteristics of articles published on the efficacy of osteopathic interventions and to provide an overall portrait of their impacts in the scientific literature. Methods A bibliometric analysis approach was used. Articles were identified with searches using a combination of relevant MeSH terms and indexing keywords about osteopathy and research designs in MEDLINE and CINAHL databases. The following indicators were extracted: country of primary author, year of publication, journals, impact factor of the journal, number of citations, research design, participants’ age group, system/body part addressed, primary outcome, indexing keywords and types of techniques. Results A total of 389 articles met the inclusion criteria. The number of empirical studies doubled every 5 years, with the United States, Italy, Spain, and United Kingdom being the most productive countries. Twenty-three articles were cited over 100 times. Articles were published in 103 different indexed journals, but more than half (53.7%) of articles were published in one of three osteopathy-focused readership journals. Randomized control trials (n = 145; 37.3%) and case reports (n = 142; 36.5%) were the most common research designs. A total of 187 (48.1%) studies examined the effects of osteopathic interventions using a combination of techniques that belonged to two or all of the classic fields of osteopathic interventions (musculoskeletal, cranial, and visceral). Conclusion The number of osteopathy empirical studies increased significantly from 1980 to 2014. The productivity appears to be very much in sync with practice development and innovations; however, the articles were mainly published in osteopathic journals targeting a limited, disciplinary-focused readership. Supplementary Information The online version contains supplementary material available at 10.1186/s12906-021-03366-3.
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Affiliation(s)
- Chantal Morin
- School of Rehabilitation, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada. .,Department of Osteopathy, Centre Ostéopathique du Québec, Montreal, Quebec, Canada.
| | - Isabelle Gaboury
- Department of Family Medicine and Emergency, Faculty of Medicine and Health Sciences, Université de Sherbrooke, Sherbrooke, Quebec, Canada
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Launay F, Ménard M, Bourgin M, Mhadhbi H, Sutre F, Draper-Rodi J. Impact of different types of revision materials on the learning of musculoskeletal techniques. INT J OSTEOPATH MED 2021. [DOI: 10.1016/j.ijosm.2020.08.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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19
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A national cross-sectional survey of the attitudes, skills and use of evidence-based practice amongst Spanish osteopaths. BMC Health Serv Res 2021; 21:130. [PMID: 33563266 PMCID: PMC7874623 DOI: 10.1186/s12913-021-06128-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2020] [Accepted: 01/21/2021] [Indexed: 12/15/2022] Open
Abstract
Background Although evidence-based practice (EBP) is largely supported across healthcare professions, its implementation in manual therapy professions such as osteopathy remains limited and debated. There is currently little knowledge of how Spanish osteopaths relate to EBP. Objectives The main aim of this study was to investigate the attitudes, skills and use of EBP among Spanish osteopaths. A secondary aim was to identify barriers and facilitators for the adoption of EBP in the Spanish osteopathic context. Methods National cross-sectional survey of Spanish osteopaths registered and non-registered to an osteopathic association in Spain. Eligible participants were invited by a range of recruitment strategies including email and social media campaigns to complete the Spanish-translated Evidence-Based practice Attitude and utilization Survey (EBASE) anonymously online. Results A total of 567 osteopaths completed the survey which represents an approximate response rate of 9%. Participant’s attitudes toward EBP were largely positive. Most respondents agreed or strongly agreed that EBP was necessary in the practice of osteopathy (89.6%) and that professional literature and research findings were useful to their day-to-day practice (88.9%). Levels of perceived skill in EBP were reported as low to moderate with lowest levels for items related to ‘research conduct’. Except reading/reviewing professional literature and using online search engines to find practice-related literature, participant engagement in all other EBP-related activities was generally infrequent. The perceived proportion of clinical practice that was based on clinical research evidence was reported to be very small. Main barriers to EBP uptake included a lack of clinical evidence in osteopathy and insufficient skills for applying research findings. Main facilitators of EBP uptake included access to full-text articles, internet at the workplace and online databases. Conclusions Spanish osteopaths were largely supportive of evidence-based practice, had low to moderate skills in EBP and engaged in EBP activities infrequently. Formal regulation of the profession in Spain and the inclusion of osteopathic programs into the university sector would potentially improve EBP skills and use. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-021-06128-6.
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20
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Leach MJ, Palmgren PJ, Thomson OP, Fryer G, Eklund A, Lilje S, Adams J, Skillgate E, Sundberg T. Skills, attitudes and uptake of evidence-based practice: a cross-sectional study of chiropractors in the Swedish Chiropractic Association. Chiropr Man Therap 2021; 29:2. [PMID: 33423697 PMCID: PMC7798252 DOI: 10.1186/s12998-020-00359-w] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/14/2020] [Indexed: 12/14/2022] Open
Abstract
Background Evidence-based practice (EBP) is integral to the delivery of high-quality health care. Chiropractic has been a licensed health profession in Sweden since 1989, but little is known of the uptake of EBP in this professional group. This study explored the self-reported skills, attitudes and uptake of EBP, and the enablers and barriers of EBP uptake, among licensed chiropractors in Sweden. Methods Licensed chiropractors (n = 172) of the Swedish Chiropractic Association (Legitimerade Kiropraktorers Riksorganisation) were invited to participate in an anonymous online questionnaire, using the Evidence-Based Practice Attitude and Utilisation Survey (EBASE) in February 2019. Results Fifty-six (33%) chiropractors completed the survey. Participants were predominantly male, aged 30–49 years, held a Master’s degree, and had received their highest qualification and practiced chiropractic for over a decade. Chiropractors rated their EBP skill-level mostly in the moderate to moderate-high range. The majority of chiropractors reported positive attitudes towards EBP, with most agreeing or strongly agreeing that EBP is necessary in the practice of chiropractic, and that EBP assists in making decisions about patient care. Chiropractors reported an average level of engagement in EBP activities. All participants indicated professional literature and research findings were useful in their day-to-day chiropractic practice. The main perceived enabler of EBP uptake was internet access in the workplace, whereas the main barrier to EBP uptake was lack of clinical evidence in chiropractic. Conclusions Participating chiropractors of the Swedish Chiropractic Association were generally favourable of EBP, though only reported modest levels of EBP-related skills and engagement in EBP activities. Our findings suggest future studies investigating interventions focussed on improving chiropractors’ skills and uptake of EBP are warranted.
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Affiliation(s)
- Matthew J Leach
- National Centre for Naturopathic Medicine, Southern Cross University, East Lismore, NSW, Australia.,Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Per J Palmgren
- Department of Learning, Informatics, Management and Ethics, Karolinska Institutet, Stockholm, Sweden
| | | | - Gary Fryer
- College of Health & Biomedicine, Victoria University, Melbourne, Victoria, Australia
| | - Andreas Eklund
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden
| | - Stina Lilje
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden
| | - Jon Adams
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia
| | - Eva Skillgate
- Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden.,Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden
| | - Tobias Sundberg
- Australian Research Centre in Complementary and Integrative Medicine, School of Public Health, Faculty of Health, University of Technology Sydney, Sydney, NSW, Australia. .,Unit of Intervention and Implementation Research for Worker Health, Institute of Environmental Medicine, Karolinska Institutet, Stockholm, Sweden. .,Musculoskeletal and Sports Injury Epidemiology Center, Department of Health Promotion Sciences, Sophiahemmet University, Stockholm, Sweden.
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21
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Vardhan V, Rajpal D, Lal M, Vyas V, Gehdoo RP, Patil S. Knowledge, attitudes, and practices of evidence-based practice among health-care professionals: Results of a cross-sectional questionnaire-based study. MEDICAL JOURNAL OF DR. D.Y. PATIL VIDYAPEETH 2021. [DOI: 10.4103/mjdrdypu.mjdrdypu_269_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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22
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Leach MJ, Shaw R, Austin P, Fryer G, Thomson OP, Adams J, Skillgate E, Sundberg T. Attitudes, skills, and use of evidence-based practice: A cross-sectional survey of Swedish osteopaths. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.10.006] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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23
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Fernández-Domínguez JC, Escobio-Prieto I, Sesé-Abad A, Jiménez-López R, Romero-Franco N, Oliva-Pascual-Vaca Á. Health Sciences-Evidence Based Practice Questionnaire (HS-EBP): Normative Data and Differential Profiles in Spanish Osteopathic Professionals. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:ijerph17228454. [PMID: 33203126 PMCID: PMC7696302 DOI: 10.3390/ijerph17228454] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/16/2020] [Revised: 11/11/2020] [Accepted: 11/13/2020] [Indexed: 12/20/2022]
Abstract
The main goal of this study was to obtain normative data of the scores of the Health-Sciences Evidence Based Practice (HS-EBP) questionnaire, and to analyse evidence-based practice (EBP) among potential clusters of osteopathy professionals in Spain. An online descriptive cross-sectional study has been applied. A total number of 443 Spanish practicing osteopaths answered a survey including the 5 dimensions of the HS-EBP questionnaire and sociodemographic, training, and practice variables using the “LimeSurvey” online platform. Results point out that the median scores for each five HS-EBP questionnaire dimensions were 95.00, 86.00, 78.00, 84.00 and 62.00 considering that the range of possible scores in each of the dimensions was: from 12 to 120 in dimensions 1, 4 and 5; from 14–140 in dimension 2; and from 10–100 in dimension 3. A clustering algorithm extracted 6 different profiles across the five HS-EBP latent dimensions: low scores in all dimensions (cluster 1); low scores in all dimensions but with medium scores in dimension 1 (cluster 2); mixed pattern of scores, low in dimensions 2 and 5 and medium in the rest of the dimensions; medium scores in all dimensions (cluster 4); high scores in all dimensions and low scores in dimension 5 (cluster 5); and high scores in all dimensions (cluster 6). Significant relationship was found among the response patterns in the clusters and: academic degree level, EBP training and training level, and work time invested in healthcare activity, research and teaching activity. These results allow a description of the actual level of EBP and differential profiles of Osteopathy care practice in Spain. Knowledge of normative scores of the HS-EBP questionnaire and identification of different predictors of Spanish osteopaths’ EBP, e.g., academic degree, EBP training and training level, work time invested in healthcare activity, research, and teaching activity, and having a working relationship with an accredited educational centre, enable a comprehensive evaluation of the EBP of osteopathic professionals and can also be useful for developing and implementing formative intervention programs for improving EBP practice in osteopathic practice.
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Affiliation(s)
- Juan Carlos Fernández-Domínguez
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain; (J.C.F.-D.); (A.S.-A.); (R.J.-L.)
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain;
| | - Isabel Escobio-Prieto
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Sevilla, Spain;
- Correspondence:
| | - Albert Sesé-Abad
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain; (J.C.F.-D.); (A.S.-A.); (R.J.-L.)
- Department of Psychology, University of the Balearic Islands, 07122 Palma, Spain
| | - Rafael Jiménez-López
- Balearic Islands Health Research Institute (IdISBa), 07120 Palma, Spain; (J.C.F.-D.); (A.S.-A.); (R.J.-L.)
- Department of Psychology, University of the Balearic Islands, 07122 Palma, Spain
| | - Natalia Romero-Franco
- Department of Nursing and Physiotherapy, University of the Balearic Islands, 07122 Palma, Spain;
| | - Ángel Oliva-Pascual-Vaca
- Department of Physiotherapy, Faculty of Nursing, Physiotherapy and Podiatry, Universidad de Sevilla, 41009 Sevilla, Spain;
- Escuela de Osteopatía de Madrid, 28002 Madrid, Spain
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Noy M, Macedo L, Carlesso L. Biomedical origins of the term 'osteopathic lesion' and its impact on people in pain. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.06.002] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
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25
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Alvarez G, Roura S, Cerritelli F, Esteves JE, Verbeeck J, van Dun PLS. The Spanish Osteopathic Practitioners Estimates and RAtes (OPERA) study: A cross-sectional survey. PLoS One 2020; 15:e0234713. [PMID: 32542047 PMCID: PMC7295231 DOI: 10.1371/journal.pone.0234713] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2020] [Accepted: 05/31/2020] [Indexed: 12/13/2022] Open
Abstract
Background Despite the growth of the osteopathic profession in Spain in the last few years, reliable information regarding professional profile and prevalence is still lacking. The Osteopathic Practitioners Estimates and RAtes (OPERA) project was developed as a European-based survey dedicated to profiling the osteopathic profession across Europe. The present study aims to describe the characteristics of osteopathic practitioners, their professional profile and the features of their clinical practice. Methods A voluntary, validated online-based survey was distributed across Spain between January and May 2018. The survey, composed of 54 questions and 5 sections, was formally translated from English to Spanish and adapted from the original version. Because there is not a unique representative osteopathic professional body in Spain, a dedicated website was created for this study, and participation was encouraged through both specific agreements with national registers/associations and an e-based campaign. Results A total of 517 osteopaths participated in the study, of which 310 were male (60%). The majority of respondents were aged between 30–39 years (53%) and 98% had an academic degree, mainly in physiotherapy. Eighty-five per cent of the respondents completed a minimum of four-year part-time course in osteopathy. Eighty-nine per cent of the participants were self-employed. Fifty-eight per cent of them own their clinic, and 40% declared to work as sole practitioner. Thirty-one per cent see an average of 21 to 30 patients per week for 46–60 minutes each. The most commonly used diagnostic techniques are movement assessment, palpation of structures/position and assessment of tenderness and trigger points. Regarding treatment modalities, articulatory/mobilisation techniques followed by visceral techniques and progressive inhibition of neuromuscular structures is often to always used. The majority of patients estimated by the respondents sought osteopathic treatment for musculoskeletal problems mainly localised on the lumbar and cervical region. The majority of respondents manifest a robust professional identity and a collective desire to be regulated as a healthcare profession. Conclusions This study represents the first published document to determine the characteristics of the osteopathic practitioners in Spain using large, national data. To date, it represents the most informative document related to the osteopathic community in Spain. It brings new information on where, how, and by whom osteopathy is practised in the country. The information provided could potentially influence the development of the profession in Spain.
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Affiliation(s)
- Gerard Alvarez
- Spain National Centre, Foundation COME Collaboration, Barcelona, Spain
- Iberoamerican Cochrane Centre–Biomedical Research Institute Sant Pau, IIB Sant Pau, Barcelona, Spain
- * E-mail:
| | - Sonia Roura
- Spain National Centre, Foundation COME Collaboration, Barcelona, Spain
| | - Francesco Cerritelli
- Clinical Human-based Research Department, Foundation COME Collaboration, Pescara, Italy
| | - Jorge E. Esteves
- Gulf National Centre, Foundation COME Collaboration, Riyadh, KSA
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Alvarez G, Van Biesen T, Roura S. Professional identity in the evolution of osteopathic models: Response to Esteves et al. INT J OSTEOPATH MED 2020. [DOI: 10.1016/j.ijosm.2020.05.001] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
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Chen L, Wu Y, Zhou C, Li X, Zhao H. Value, knowledge and implementation on evidence‐based practice among nurse managers in china: A regional cross‐sectional survey. J Nurs Manag 2020; 28:139-147. [PMID: 31746069 DOI: 10.1111/jonm.12907] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2019] [Revised: 11/14/2019] [Accepted: 11/18/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Liling Chen
- Nanfang Hospital Southern Medical University Guangzhou China
| | - Yanni Wu
- Nanfang Hospital Southern Medical University Guangzhou China
| | - Chunlan Zhou
- Nanfang Hospital Southern Medical University Guangzhou China
| | - Xiaoxia Li
- Nanfang Hospital Southern Medical University Guangzhou China
| | - Huihui Zhao
- Nanfang Hospital Southern Medical University Guangzhou China
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Abstract
Evidence-based practice (EBP) arises from evidence-based medicine (EBM). The latter represents a movement of thought born in the second half of the 19th century, while the EBP is born since the new millennium, represented by different scientific figures and professional associations. The EBP is the research for the best practical and clinical strategies, with the ultimate goal of determining guidelines. The improvement of manual osteopathic practice derives from the balanced mix of scientific research, operator experience and patient experience. The text reviews the benefits and limitations of EBP in the osteopathic field. We must remember that knowledge, both theoretical and practical, is always evolving and we must not stop at what appears to be a dogma. Science and knowledge are always evolving, and hence, we must always study and update ourselves.
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Affiliation(s)
- Bruno Bordoni
- Cardiology, Foundation Don Carlo Gnocchi, Milan, ITA
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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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Wallden M, Chek P. The ghost in the machine - A response to Thomson et al. J Bodyw Mov Ther 2019; 23:221-228. [DOI: 10.1016/j.jbmt.2019.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 03/08/2019] [Indexed: 11/30/2022]
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Complementing or conflicting? A qualitative study of osteopaths’ perceptions of NICE low back pain and sciatica guidelines in the UK. INT J OSTEOPATH MED 2019. [DOI: 10.1016/j.ijosm.2019.01.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022]
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