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Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students
BACKGROUND: While there is a broad spectrum of practice within chiropractic two sub-types can be identified, those who focus on musculoskeletal problems and those who treat also non-musculoskeletal problems. The latter group may adhere to the old conservative ‘subluxation’ model. The main goal of th...
Autores principales: | , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379950/ https://www.ncbi.nlm.nih.gov/pubmed/30820316 http://dx.doi.org/10.1186/s12998-018-0227-6 |
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author | Goncalves, Guillaume Demortier, Marine Leboeuf-Yde, Charlotte Wedderkopp, Niels |
author_facet | Goncalves, Guillaume Demortier, Marine Leboeuf-Yde, Charlotte Wedderkopp, Niels |
author_sort | Goncalves, Guillaume |
collection | PubMed |
description | BACKGROUND: While there is a broad spectrum of practice within chiropractic two sub-types can be identified, those who focus on musculoskeletal problems and those who treat also non-musculoskeletal problems. The latter group may adhere to the old conservative ‘subluxation’ model. The main goal of this study is to determine if chiropractic students with such conservative opinions are likely to have a different approach to determine contra-indications, non-indications and indications to chiropractic treatment versus those without such opinions. METHOD: An anonymous and voluntary survey on 3rd to 6th year French chiropractic students was conducted between November 2017 and January 2018. Level of chiropractic conservatism (10 items) and the ability to determine contra-indications (2 cases), non-indications (4 cases) and indications (3 cases) were evaluated through a questionnaire. Answers to these cases were dichotomized into ‘appropriate’ and ‘inappropriate’ answers, as defined by previous research teams and the present team. The level of conservatism was classified into four groups, ‘group 4’ corresponding to the highest score. Descriptive data are provided, and bi- and multivariate analyses were performed through logistic regression to test the associations between the level of conservatism and the ability to determine the suitability of chiropractic treatment. RESULTS: In all, 359 of 536 (67%) students responded to the questionnaire. They generally recognized a number of contra-indications and indications to treatment. However, they found it more difficult to identify non-indications. The more conservative students were more likely to intend to treat their patients, even if this was irrelevant (non-indications). For example, those who were most conservative (group 4) were much more willing than those in group 1 to treat ‘chiropractically’ a 5-year-old child with no history of back pain or disease to prevent future back pain (OR = 14.7) and also to prevent non-musculoskeletal disease (OR = 22). CONCLUSION: It is concerning that students who adhere to the subluxation model are prepared to ‘operationalize’ their conservative opinions in their future scope of practice; apparently willing to treat asymptomatic people with chiropractic adjustments. The determinants of this phenomenon need to be understood. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12998-018-0227-6) contains supplementary material, which is available to authorized users. |
format | Online Article Text |
id | pubmed-6379950 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-63799502019-02-28 Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students Goncalves, Guillaume Demortier, Marine Leboeuf-Yde, Charlotte Wedderkopp, Niels Chiropr Man Therap Research BACKGROUND: While there is a broad spectrum of practice within chiropractic two sub-types can be identified, those who focus on musculoskeletal problems and those who treat also non-musculoskeletal problems. The latter group may adhere to the old conservative ‘subluxation’ model. The main goal of this study is to determine if chiropractic students with such conservative opinions are likely to have a different approach to determine contra-indications, non-indications and indications to chiropractic treatment versus those without such opinions. METHOD: An anonymous and voluntary survey on 3rd to 6th year French chiropractic students was conducted between November 2017 and January 2018. Level of chiropractic conservatism (10 items) and the ability to determine contra-indications (2 cases), non-indications (4 cases) and indications (3 cases) were evaluated through a questionnaire. Answers to these cases were dichotomized into ‘appropriate’ and ‘inappropriate’ answers, as defined by previous research teams and the present team. The level of conservatism was classified into four groups, ‘group 4’ corresponding to the highest score. Descriptive data are provided, and bi- and multivariate analyses were performed through logistic regression to test the associations between the level of conservatism and the ability to determine the suitability of chiropractic treatment. RESULTS: In all, 359 of 536 (67%) students responded to the questionnaire. They generally recognized a number of contra-indications and indications to treatment. However, they found it more difficult to identify non-indications. The more conservative students were more likely to intend to treat their patients, even if this was irrelevant (non-indications). For example, those who were most conservative (group 4) were much more willing than those in group 1 to treat ‘chiropractically’ a 5-year-old child with no history of back pain or disease to prevent future back pain (OR = 14.7) and also to prevent non-musculoskeletal disease (OR = 22). CONCLUSION: It is concerning that students who adhere to the subluxation model are prepared to ‘operationalize’ their conservative opinions in their future scope of practice; apparently willing to treat asymptomatic people with chiropractic adjustments. The determinants of this phenomenon need to be understood. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (10.1186/s12998-018-0227-6) contains supplementary material, which is available to authorized users. BioMed Central 2019-02-19 /pmc/articles/PMC6379950/ /pubmed/30820316 http://dx.doi.org/10.1186/s12998-018-0227-6 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Goncalves, Guillaume Demortier, Marine Leboeuf-Yde, Charlotte Wedderkopp, Niels Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students |
title | Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students |
title_full | Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students |
title_fullStr | Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students |
title_full_unstemmed | Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students |
title_short | Chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students |
title_sort | chiropractic conservatism and the ability to determine contra-indications, non-indications, and indications to chiropractic care: a cross-sectional survey of chiropractic students |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6379950/ https://www.ncbi.nlm.nih.gov/pubmed/30820316 http://dx.doi.org/10.1186/s12998-018-0227-6 |
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