Browsing by Author "Myburgh, Corrie"

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    "Methodological and epistemological challenges for the chiropractic profession in health care - a study of the history, status quo and future of research and clinical practices."
    (Stellenbosch : University of Stellenbosch, 2011-10) Myburgh, Corrie; Mouton, J.; University of Stellenbosch. Faculty of Arts and Social Sciences. Dept. of Sociology and Social Anthropology.
    ENGLISH ABSTRACT: Although a legitimate provider of manipulative therapy, chiropractic largely functions outside mainstream health care in South Africa. A narrow research focus, poor institutional representation and inadequate professional integration all contribute to its undetermined role in health care. This study exploratory, qualitative study sought to investigate the state of the art of chiropractic with respect to beliefs, philosophy, research methods and clinical practices. Semi-structured, interviews were used to extract responses from ten chiropractors, six patients and four researchers. The results were interpreted on three levels; thematically, in relation to chiropractic’s discipline and profession and as a function of the ‘3 worlds’ framework. The thematic analysis revealed that: 1. Beliefs and philosophical traditions play an active role in the practice and science of chiropractic. 2. The chiropractic investigative paradigm has started to mature. 3. The contextual role of research methods is being clarified. 4. Contemporary chiropractic practice is not as evidence-based as it should be. 5. The chiropractic model of practice is significantly different to the perceived standard medical model. 6. Chiropractic clinical practice has a fuzzy identity. 7. Chiropractic’s professional status is unclear. 8. The professional and disciplinary components of chiropractic are still institutionally immature. 9. Chiropractic’s legitimacy is questionable. Themes 1-3 indicated that beliefs and philosophical traditions affect the way in which chiropractors conduct themselves clinically, the way patients view the world of health care and the manner in which researchers study clinical phenomena. Themes 4-6 suggest that the state of the art of chiropractic clinical practice is different from medicine, however the exact nature of its model of practice seems quite fluid. Themes 7, 8 and 9 suggest that the degree of professional and institutional maturity provide chiropractic with only partial legitimization.With regards to the discipline it seems that science and education have an important buffering role to play between the patient and the practitioner, in order to curb metaphysically motivated practices. Furthermore, chiropractic’s investigative paradigm is progressing atypically and hence the view of it conforming to a standard view of science is questioned. With regards to professional matters, our study indicates that chiropractors function on a spectrum which runs between “technicians” and “physicians”. Whilst patients have holistic health care beliefs it seems they are pushed toward chiropractic, through negative allopathic health care experiences and are drawn to the profession by its integrated model of practice. However, the lack of mainstream healthcare integration counter balances this worth and reduces chiropractic’s professional legitimacy. Two cross over themes were revealed. Firstly, chiropractic’s investigative paradigm has started to narrow the gap between applied science and clinical practice and secondly chiropractic’s legitimacy cannot lie in the opinion of medicine. The ‘three worlds’ framework indicated that the first three themes are meta-scientific (W3) reflections on beliefs, philosophical traditions and research methodology. The fourth theme reflects the relationship of research and practice (W2 and W1), and the remaining five themes are reflections clinical practice (W1 activities). Our study contends that chiropractic has the potential to develop into a mainstream health care provider through the implementation of a multi-leveled development strategy.