Development and validation of the Chiropractic Professional Identity Embodiment Scale (CPIES)

BACKGROUND AND PURPOSE

Chiropractic professional identity (CPI) encompasses diverse values, beliefs, experiences, and philosophies about one's work, specific to the chiropractic profession. Yet currently, there is no instrument available to measure CPI. This study aimed to develop and validate the Chiropractic Professional Identity Embodiment Scale (CPIES).

MATERIALS AND METHODS

A mixed-methods sequential exploratory design was employed where qualitative inquiry preceded quantitative analysis of survey items conducted in New Zealand in 2022. Expert key informants provided feedback on candidate items via one-to-one cognitive interviews. Candidate items were administered to Board-registered chiropractors or chiropractic students through an online survey. The suitability of candidate items was evaluated using a variety of psychometric analyses including conceptually guided exploratory factor analysis (EFA) and reliability testing.

RESULTS

Based on relevant professional identity literature and feedback from 15 expert key informants, a draft survey instrument with 92 candidate items (across six domains) was rated by 231 participants. Using EFA, the number of items was reduced to 15. The CPIES sum score exhibited significant correlations with individuals' philosophical self-categorisation and five of the six optional subscales.

CONCLUSION

The 15-item CPIES, either as a unidimensional score or with six separate subscale scores, has been demonstrated to provide valid and reliable measurement of CPI. Future research could utilise the CPIES to investigate how CPI influences clinical practice, patient outcomes, career satisfaction, and public perception of the chiropractic profession, further advancing professionalisation and recognition within healthcare.

Defining chiropractic professional identity: A concept analysis

BACKGROUND

The concept of professional identity within chiropractic is often discussed and debated, however in the field to date, there is no formal definition of chiropractic professional identity (CPI). This article aims to create a coherent definition of CPI and to formalise the conceptual domains that may encompass it.

METHODS

Using the Walker and Avant (2005) process, a concept analysis methodology was employed to clarify the diffuse concept of CPI. This method initially involved selecting the concept (CPI), determining the aims and purpose of the analysis, identifying concept uses, and defining attributes. This was achieved from a critical literature review of professional identity across health disciplines. Chiropractic-related model, borderline and contrary cases were used to exemplify characteristics of CPI. The antecedents required to inform CPI, consequences of having, and ways to measure the concept of CPI were evaluated.

RESULTS

From the concept analysis data, CPI was found to encompass six broad attributes or domains: knowledge and understanding of professional ethics and standards of practice, chiropractic history, practice philosophy and motivations, the roles and expertise of a chiropractor, professional pride and attitude, and professional engagement and interaction behaviours. These domains were not mutually exclusive and may overlap.

CONCLUSION

A conceptual definition of CPI may bring together members and groups within the profession and promote intra-professional understanding across other disciplines. The CPI definition derived from this concept analysis is: 'A chiropractor's self-perception and ownership of their practice philosophies, roles and functions, and their pride, engagement, and knowledge of their profession'.

Chiropractors' Perspectives on the Meaning and Assessment of Quality of Life Within Their Practice in New Zealand: An Exploratory Qualitative Study

OBJECTIVE

The purpose of this study was to gain an understanding on what quality of life (QOL) and its assessment means to chiropractors in everyday practice.

METHODS

This study captured chiropractors' perspectives on the QOL construct and its assessment using a qualitative descriptive methodology that comprised 2 focus groups, each with 4 participants using semi-structured, open-ended questioning. Participants from Aotearoa, New Zealand, were also asked to evaluate 4 QOL patient-reported outcome measurements from a clinical perspective.

RESULTS

Two of the participants were faculty at the New Zealand College of Chiropractic, 5 were in full-time practice, and 1 was practicing part time. Using qualitative content analysis, 3 main themes were identified. These chiropractors perceived that patients have misconceptions about how chiropractic can affect QOL. They lacked clarity in communicating QOL and its related concepts to establish a clinically meaningful patient encounter. Finally, there is uncertainty in how and when to measure QOL, which appears to affect how they discuss and assess QOL in practice.

CONCLUSION

There is a complex combination of factors that makes communication regarding QOL challenging. This exploratory qualitative study helps to understand the challenges faced in how and when to communicate and assess QOL more effectively in chiropractic practice.

A Survey of the Public Perception of Chiropractic After Exposure to Chiropractic Public Place Marketing Events in New Zealand

OBJECTIVE

The purpose of this study was to assess public perception of chiropractic public place marketing events.

METHOD

A chiropractic public place marketing program was held at 3 events (a community sports event, an exposition, and a university campus market day) over a 5-month period in Auckland, New Zealand, between 2008 and 2009. Participants were interviewed by chiropractic students. Interview questions were standardized and sought to find out participants' perception of chiropractic and whether it was influenced in a positive or negative manner after their exposure to the marketing program.

RESULTS

Three hundred forty-five interviews were completed during 3 events. The minority of participants (15.9%) had a negative view of chiropractic, 29.2% were neutral, and 54.9% had a positive view of chiropractic. Of the responses of those surveyed, 54% did not change their opinion of chiropractic, 44.3% were more positive, and 1.7% were more negative.

CONCLUSIONS

This study found that direct or indirect exposure to chiropractic public place marketing events may possibly influence the public perception of chiropractic. Because of the limited sample, these findings cannot be extrapolated to other regions or populations. Further studies are needed to test these findings in other world regions and in more controlled environments.