Quiet Dissent: insights into attitudes, beliefs and behaviours in respect of evidence-based guidance for the management of low back pain among UK osteopaths.
Item
- Title
- Quiet Dissent: insights into attitudes, beliefs and behaviours in respect of evidence-based guidance for the management of low back pain among UK osteopaths.
- Author(s)
- Figg-Latham, J
- Abstract
- INTRODUCTION The best evidence from research has been translated into clinical guidance to improve quality of primary care for acute low back pain. This effort to modify clinical behaviour is resisted by some osteopaths, and their attitudes and beliefs present obstacles to the adoption of these guidelines. The aim of this study is to explore the attitudes and beliefs of osteopaths in clinical education who do not agree with the guidance, or the research upon which it is based. The study was designed to identify and understand what influences osteopathic practice in respect to guidance, and provide insight into these beliefs. METHOD A mixed methods study, combining the use of a questionnaire and interviews, to assess the attitudes and beliefs of students and osteopaths at the European School of Osteopathy (ESO). This phenomenological study used the constant comparative method to code and analyse twelve interviews and identify the main themes.RESULTS Four interdependent themes were identified: 1. The perceived precedence of osteopathy over mainstream medicine and other manual therapies; 2. What osteopaths believe about self; 3. Osteopaths’ perception of others; 4. Osteopaths’ attitudes to research and clinical guidance. Theme 1 is the core theme around which the other three themes revolve. DISCUSSION This sample of osteopaths possesses a strong sense of professional identity which bestows autonomy, authority and distinctness upon them. These attributes are perceived as differentiating them from mainstream and other manual therapies. Their beliefs influence their ‘Conception of practice’ that is developed in education. Guidance, and the research upon which it is based, is explicitly rejected, yet in practice, is followed. Guideline education is erratic. CONCLUSION This research has provided insight into the attitudes and beliefs of a group of practitioners and students who perceive threat from, and reject evidence-based guidance. This is because expert opinion, rather than any other forms of evidence is recognized. This study has exposed paternalistic practice, based on a belief in authority over a patient and conferred by a strong sense of professional identity. There is a dichotomy between private practice, where osteopathic philosophy guides practice, and NHS, where practitioners follow evidence-based guidelines without necessarily agreeing with them. This behaviour reflects a response to changes in the health-care market.
- presented at
- European School of Osteopathy
- Date Accepted
- 2014
- Date Submitted
- 20.1.2015 16:43:40
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 15494
- Inst-Identifier
- 1229
- Keywords
- Practitioner, Attitudes, Guideline, NICE
- Recommended
- 0
- Item sets
- Thesis
Figg-Latham, J, “Quiet Dissent: insights into attitudes, beliefs and behaviours in respect of evidence-based guidance for the management of low back pain among UK osteopaths.”, Osteopathic Research Web, accessed May 17, 2024, https://www.osteopathicresearch.com/s/orw/item/670