Ways of seeing: A qualitative phenomenological study of the approach of practising osteopaths on differential diagnosis of lower back pain.
Item
- Title
- Ways of seeing: A qualitative phenomenological study of the approach of practising osteopaths on differential diagnosis of lower back pain.
- Author(s)
- Novo Fernandez, A
- Abstract
- INTRODUCTION: Osteopathy has undertaken since the 1980's (Thompson et al, 2011) the incorporation of evidence-based practice. The trend of introducing evidence-based medicine has greatly influenced the evolution of clinical reasoning and differential diagnosis of lower back pain both within conventional medicine and osteopathy. Nonetheless, as Stempsey (2009) points out: " a clinical encounter is a human encounter, and not a mathematical encounter" and good clinical reasoning still challenges modelling. In addition, Randomised Control Trials are according to Brande (2011) frequently used against medical experience. Thus, this study intends to help in making explicit the mechanisms that bridge between the macro (Differential diagnosis based upon Randomized Control trials and qualitative research) and the micro (The presentation of the patient considered) within a clinical setting by practicing osteopaths. METHODS: The method consists of a phenomenological study of the "interrelation of case analyses" {Flick, 2009), which were initially carried out individually and then compared to each other. The subjects of this study were 10 practising osteopaths (5 male and 5 female) that are either clinic tutors or teachers at the European School of Osteopathy. Episodic expert interviews are the technique used for this study. The subjects answered some questions related to their latest new patient presenting with lower back pain. A thematic analysis approach was used to analyze the data. RESULTS: This phenomenological study of "differential diagnosis of lower back pain" found twelve relevant themes :1 concepts and approaches, 2.osteopathic models, 3.awareness of other approaches, 4. osteopathic or orthopedic diagnosis 5.background, 6. palpation, 7. intuition, 8. professional artistry, 9. current research, 10. NICE guidelines, 11. formulation of diagnosis, 12.enrichment. DISCUSSION: The theme "background" occupies a central position and act as a fulcrum in relation to the themes I ,2,3,4,6,7 and 12. The themes "NICE guidelines" and "current research" influence the phenomenon and elicit the positioning of the participants, mainly, so far as the themes "approach" and "osteopathic or orthopedic differential diagnosis" are concerned, which leads to a specific "formulation of diagnosis". In addition, data coming from "palpation" (theme 6) and intuition (theme 7) are valued by most practioners as diagnostic tools, in spite of the difficulty to quantify them.
- presented at
- European School of Osteopathy
- Date Accepted
- 2013
- Date Submitted
- 20.1.2015 16:42:59
- Type
- osteo_thesis
- Language
- English
- Submitted by:
- 62
- Pub-Identifier
- 15465
- Inst-Identifier
- 1229
- Keywords
- Differential diagnosis.
- Recommended
- 0
- Item sets
- Thesis
Novo Fernandez, A, “Ways of seeing: A qualitative phenomenological study of the approach of practising osteopaths on differential diagnosis of lower back pain.”, Osteopathic Research Web, accessed May 17, 2024, https://www.osteopathicresearch.com/s/orw/item/699