M.Tech.

Dissertation submitted in partial compliance with the requirements for a Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2012. / Background: Animal chiropractic, an internationally sanctioned profession, assists veterinarians with a complementary approach to animal healthcare therapy. Animal chiropractic in South Africa appears to be within its novel stages of development and no clear parameters define its present position. As a result of ambiguity and present concern dictated by veterinary regulation, animal chiropractic has not developed along well defined parameters, and it is thought that this study will contribute to achieving some clarity in this regard. The impetus for this study originated as a result of an increased awareness within the complementary and alternative medicine (CAM) field of these CAM therapies in the management of animal healthcare, and a growing interest in their application. Objective: The purpose of the study is to identify the current status of animal chiropractic in South Africa and to explore ways in which the integration of animal chiropractic into the animal healthcare setting of South Africa might be achieved. Method: This study is an interpretive investigation set in a post-positivistic paradigm and used a grounded theory approach. Data was collected from twelve semi-structured interviews (digitally voice recorded) with relevant stakeholders who were knowledgeable within their respective fields (animal chiropractic; veterinary health science; their respective governing bodies; and owners of animals which had received treatment from animal chiropractic). Questions addressed participants’ perceptions and experiences of animal chiropractic with regard to the role it plays, current interprofessional interactions and developmental issues facing the profession. Qualitative analysis of the data was done using NVIVO 9 software (NVivo 9, developed in Australia, copyright 2011 QSR International Pty Ltd.). The purpose of the data collection was to obtain knowledge presently available within the proposed field in order to build a credible theory which might explain the current status of animal chiropractic in South Africa and the way forward to professional integration with mainstream animal healthcare practice. iv Results: Applying a process of grounded theory methodology revealed that certain key prerequisites were needed for integration of animal chiropractic with mainstream animal healthcare to take place. Firstly, animal chiropractic practitioners had to be seen to have reached a certain level of competence, which could be achieved through a recognised educational programme and by following practising standards at the same (or similar) level as veterinary practitioners. Secondly, acceptance by the public and mainstream practitioners is vital, and requires that the need for animal chiropractic is well motivated, that the role of animal chiropractic is better defined, and that collaboration with mainstream professionals is implemented. Thirdly, animal chiropractic needs careful regulation in order for it to be controlled appropriately. This will require a suitable professional body to govern it, legislation to endorse it and guidelines to direct its actions. Lastly, resources must be available, such as enough animal chiropractors interested in entering the field, sufficient qualified instructors (i.e. experienced animal chiropractors) to provide tuition, adequate amenities, and sufficient time available for the profession to develop and the integration process to take place. Conclusion: It would appear that, with CAVM therapies becoming popular, more people are becoming interested in animal chiropractic. The study suggests that, if the animal chiropractic profession makes provision for achieving the prerequisites of competence, acceptance, regulation and resources in terms of its future development, it might be possible to achieve professional integration with mainstream animal healthcare within the next ten years.

Dissertation in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, in the Department of Chiropractic, Durban University of Technology, 2010. / Background: Chiropractic in South Africa seems to be gaining acceptance by medicine with increased recognition from the private healthcare sector. This trend is reflected by the recognition of private healthcare providers of chiropractic services. Integration would accelerate the growth of the chiropractic profession in this country. It is therefore important to understand how chiropractic is currently perceived with respect to integration into the KwaZulu-Natal (KZN) healthcare system. As well as to determine factors perceived to facilitate or hinder this integration. Objectives: To explore and describe the perceptions of selected stakeholders about the integration of the chiropractic profession into the KZN healthcare system. Method: The sample included ten selected stakeholders within the KZN healthcare sector. Each participant participated in a semi-structured interview. Questions included participants‟ experience of chiropractic, the role and scope of chiropractic practice, and key developmental issues affecting integration. Interviews were captured on a digital voice recorder and transcribed into text. Data was analysed by the use of NVivo software (NVivo 8, developed and designed in Australia, copyright 2008 QSR International Pty Ltd. ABN 47 006 357 213). Results: The majority of participants (n = 7) had a positive experience of chiropractic, but few (n= 2) recognised the diagnostic role of chiropractic. All participants, except two doctors, believed that integrating chiropractic into the public healthcare system would benefit the healthcare fraternity, the chiropractic profession and patients. However, hindering factors perceived by the participants included: chiropractors practicing non-evidence based techniques; chiropractic being registered with a different council and being taught at a different institution to conventional medical professionals; and most importantly a lack of knowledge of the profession. Facilitating factors were III perceived to be: increased education of stakeholders about chiropractic; improved communication between chiropractors and medical doctors; improved marketing strategy; and lastly improved patient management. Conclusions: A positive experience of chiropractic is directly affected by a positive exposure to the profession. The profession itself is responsible for dispelling some of the confusion it has created, by collectively practicing evidence based medicine, and marketing a united message to stakeholders.

Dissertation submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, Durban University of Technology, 2010. / Objectives: To investigate the perception, knowledge and utilization of chiropractic profession by Durban University of Technology students. Methods: One thousand quantitative questionnaires were handed to students during lecture times. The sample was selected through representative sampling of all the Durban University of Technology students. The questionnaire was developed utilizing a Delphi process of focus group refinement and piloting. Data was entered on the spread sheet into the computer using SPSS version 15.0. Results: A response rate of 94,6% (946/1000) was obtained. There was a low level of knowledge, perception and utilization of chiropractic amongst Durban University of Technology students, only 37% had knowledge about chiropractic which most of them admitted to having a fair knowledge . White females had a higher knowledge about chiropractic than any other group. The perceptions about the suitability of chiropractic to treat different conditions were low. Low back pain was the condition for which respondents most commonly consulted a chiropractor, with 30% of participants being referred by a doctor and another 30% referred by family members. Conclusions: The overall knowledge of chiropractic in this population was relatively poor but a better perception of chiropractic existed in some ethnic groups which was not statistically significant. The results indicated that no statistic significance relationship exists between demographic factors and perception and knowledge of DUT students with respect to chiropractic.

Dissertation in partial compliance with the requirements for a Master's Degree in Technology: Chiropractic, in the Department of Chiropractic, Durban University of Technology, 2010. / Background: Chiropractic in South Africa seems to be gaining acceptance by medicine with increased recognition from the private healthcare sector. This trend is reflected by the recognition of private healthcare providers of chiropractic services. Integration would accelerate the growth of the chiropractic profession in this country. It is therefore important to understand how chiropractic is currently perceived with respect to integration into the KwaZulu-Natal (KZN) healthcare system. As well as to determine factors perceived to facilitate or hinder this integration. Objectives: To explore and describe the perceptions of selected stakeholders about the integration of the chiropractic profession into the KZN healthcare system. Method: The sample included ten selected stakeholders within the KZN healthcare sector. Each participant participated in a semi-structured interview. Questions included participants‟ experience of chiropractic, the role and scope of chiropractic practice, and key developmental issues affecting integration. Interviews were captured on a digital voice recorder and transcribed into text. Data was analysed by the use of NVivo software (NVivo 8, developed and designed in Australia, copyright 2008 QSR International Pty Ltd. ABN 47 006 357 213). Results: The majority of participants (n = 7) had a positive experience of chiropractic, but few (n= 2) recognised the diagnostic role of chiropractic. All participants, except two doctors, believed that integrating chiropractic into the public healthcare system would benefit the healthcare fraternity, the chiropractic profession and patients. However, hindering factors perceived by the participants included: chiropractors practicing non-evidence based techniques; chiropractic being registered with a different council and being taught at a different institution to conventional medical professionals; and most importantly a lack of knowledge of the profession. Facilitating factors were III perceived to be: increased education of stakeholders about chiropractic; improved communication between chiropractors and medical doctors; improved marketing strategy; and lastly improved patient management. Conclusions: A positive experience of chiropractic is directly affected by a positive exposure to the profession. The profession itself is responsible for dispelling some of the confusion it has created, by collectively practicing evidence based medicine, and marketing a united message to stakeholders. / M

A dissertation presented to the Faculty of Health Sciences at the Durban University of Technology in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, 2009 / Previously it was established that the majority of medical professions such as Orthopaedic surgeons, Neurosurgeons and Neurologists were not comfortable with the Chiropractic Profession. Changes have occurred since this perception was established so it was considered necessary to review the knowledge and perception of these three medical professions in order to ascertain any changes. Objectives The objectives were to establish the demographic factors of Orthopaedic surgeons, Neurosurgeons and Neurologists, whilst also establishing their current views and perceptions of the Chiropractic profession in South Africa in terms of their personal experience of Chiropractic, Chiropractic therapeutic efficacy, the Chiropractic scope of practice and inter-professional relations. Methods This prospective, qualitative questionnaire study required that all 478 Orthopaedic surgeons, 110 Neurosurgeons, and 101 Neurologists who were registered with the Health Professions Council of South Africa at the time receive a questionnaire. Thus a total of 689 Questionnaires were sent out for completion. Results The overall views and perceptions of participating Orthopaedic surgeons, Neurosurgeons and Neurologists regarding Chiropractic has made a positive shift in favour of developing and potentially expanding relations between these professions and the Chiropractic profession. This has been shown by the increased confidence these professions have in the Chiropractic profession both in terms of effectiveness of Chiropractic treatment for neuromusculoskeletal and other conditions, as well as the increased rate of referral between these professions and Chiropractors.

Mini-dissertation in partial compliance with the requirements for the Masters Degree in Technology: Chiropractic, Durban University of Technology, 2009. / Aim: The aim of this study was to establish the relationship between demographics of honourable members, their level of knowledge of and the perceptions of the chiropractic profession. Methods: A questionnaire-based survey was administered to 84 Health Portfolio Committee (HPC) members at their meetings as requested through the respective committee secretaries. The questionnaire was administered in a semi supervised fashion at the set meetings. Results: A response rate of 64% revealed that the mean knowledge score of 31.4% was relatively low. The mean perceptions score was 38.2%, indicating an overall negative perception of chiropractic amongst this population. Experience did indeed influence perceptions significantly (p=0.035) with those having consulted a chiropractor before having higher perceptions scores. No significant correlations existed between knowledge and perception and the demographic variables with the exception of ethnicity. This was enhanced by a weak statistically significant positive correlation between knowledge and perceptions score (r=0.394, p=0.004). The weak strength of the correlation shows that in general, as knowledge increased so did perceptions. Conclusion: Generally knowledge and perception of chiropractic was low in this population and seems to be influenced principally by the ethnicity / culture within which the honourable members operate (whether it is within the medical paradigm or their individual cultural orientation). Thus increasing the awareness and knowledge of chiropractic in this group may lead to more positive knowledge scores and perception levels.

Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic, Durban University of Technology, 2011. / Introduction: The chiropractic treatment of animals has been integrated into the veterinary health care systems of various countries outside of South Africa. While South Africa has seen the integration of the chiropractic treatment of humans into its health care system, the chiropractic treatment of animals has been slow to develop in this country. This is evident in the lack of a professional association or education system concerning the chiropractic treatment of animals in South Africa. Veterinarians represent the primary contact for animals to receive chiropractic care through referral in South Africa. It is therefore important to ascertain the knowledge and perception that veterinarians have towards chiropractic and the chiropractic treatment of animals as their views and participation could influence the future integration of chiropractic into the veterinary health care system of South Africa. Primary Objective: To determine the perception of veterinarians towards chiropractic and the chiropractic treatment of animals in South Africa. Methods: A questionnaire was set up on an Internet based website. An electronic mail (e-mail) was then sent to all the South African veterinarians with a functional e-mail address registered with the South African Veterinary Council (SAVC), requesting participation in this research. This amounted to 1841 veterinarians. The veterinarians who met the inclusion criteria were then able to access and complete the questionnaire electronically. Results: A response rate of 13.8% was achieved. The respondents were predominantly white (87.1%) with an average age of 41.5 years and a nearly even split between male and female. The veterinary respondents expressed a poor level of confidence relating to their knowledge of chiropractic and its application to the health care of animals. The objective knowledge scores for chiropractic and the chiropractic treatment of animals were 65% and 63%, respectively, giving a reasonably high overall knowledge score of 64%. It was found that the knowledge scores were stronger in the respondents who had iii personally utilized a chiropractor as well as being stronger regarding human chiropractic and overall chiropractic knowledge in those who had referred an animal to a chiropractor. The average score for perceptions of the respondents was relatively low (48%), but positive correlations were found between the knowledge and perceptions of the respondents regarding chiropractic and \ or the chiropractic treatment of animals. It was found that the majority of the veterinarian respondents (79.9%) felt that chiropractors should only be allowed to practice on animals in South Africa under referral from a veterinarian. The majority of respondents (62.4%) further believed that the chiropractic treatment of animals should be governed by the South African Veterinary Council (SAVC) and 57.7 % of the respondents indicated that they would be in favour of the chiropractic treatment of animals being affiliated to the South African Veterinary Association (SAVA). It was determined that 84.4% of the respondents were in support of the formation of a course concerning the chiropractic treatment of animals in South Africa, with 49.1% further stating they would be interested in attending such a course. The majority of respondents indicated that they believed both veterinarians and chiropractors should administer (77.2%) and be able to attend (75.1%) such a course. Conclusion: This study has established a knowledge base that will facilitate greater understanding of the perceptions that South African veterinarians have towards chiropractic and the chiropractic treatment of animals as well as the part they perceive chiropractic to play in the South African veterinary health care system. The various outcomes should be noted when considering the future education of South African veterinarians regarding chiropractic, as well as the development of the chiropractic treatment of animals in South Africa.

Submitted in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic at the Durban University of Technology, 2013. / Background: Paediatric visits to complementary and alternative medicine (CAM) practitioners results from a wide range of childhood disorders. As there are significant anatomical differences between children and adults, scientific evidence for the effectiveness of chiropractic care for adults is not applicable to paediatrics, leaving a paucity of information supporting the management of paediatric conditions by chiropractors. Most studies regarding paediatrics have been performed in first world countries, leaving a paucity of information about third world countries, where the health care milieu differs. Therefore, this research aimed to determine the practice characteristics regarding paediatric care in chiropractic practices in KwaZulu-Natal. Objectives: This prospective, quantitative, descriptive, cross-sectional study based on a focus group refined and piloted questionnaire, determined the practice characteristics with regards to paediatric practice amongst chiropractors in KwaZulu-Natal. The total sample population was n=118, with each practitioner receiving a Letter of Information and Informed Consent Form and a Questionnaire. Data was analysed using the data analysis tools of Microsoft Office Excel and a p value of <0.05 was considered as statistically significant. Results: A response rate of 36% was obtained. Most of the respondents were middle-aged, female chiropractors who had been practicing for less than a decade. Very few of the chiropractors held paediatric qualifications (18.6%). In terms of paediatric care, most of the respondents used a variety of conservative approaches as evidenced by the type and number of assessments, treatment and management procedures used in practice. Conclusions: The results showed that few chiropractors in KwaZulu-Natal see paediatric patients in their practices; however the chiropractors that managed paediatric conditions were predominantly conservative. This is positive for the chiropractic profession, as it shows diligent and responsible decision making within a vulnerable population group. Future research must assist with facilitating inter-professional relations with other health care professionals and public relations need to be aimed at creating more awareness generally regarding chiropractic paediatric care. / M

A dissertation presented to the Faculty of Health Sciences at the Durban University of Technology in partial compliance with the requirements for the Master's Degree in Technology: Chiropractic, 2009 / Previously it was established that the majority of medical professions such as Orthopaedic surgeons, Neurosurgeons and Neurologists were not comfortable with the Chiropractic Profession. Changes have occurred since this perception was established so it was considered necessary to review the knowledge and perception of these three medical professions in order to ascertain any changes. Objectives The objectives were to establish the demographic factors of Orthopaedic surgeons, Neurosurgeons and Neurologists, whilst also establishing their current views and perceptions of the Chiropractic profession in South Africa in terms of their personal experience of Chiropractic, Chiropractic therapeutic efficacy, the Chiropractic scope of practice and inter-professional relations. Methods This prospective, qualitative questionnaire study required that all 478 Orthopaedic surgeons, 110 Neurosurgeons, and 101 Neurologists who were registered with the Health Professions Council of South Africa at the time receive a questionnaire. Thus a total of 689 Questionnaires were sent out for completion. Results The overall views and perceptions of participating Orthopaedic surgeons, Neurosurgeons and Neurologists regarding Chiropractic has made a positive shift in favour of developing and potentially expanding relations between these professions and the Chiropractic profession. This has been shown by the increased confidence these professions have in the Chiropractic profession both in terms of effectiveness of Chiropractic treatment for neuromusculoskeletal and other conditions, as well as the increased rate of referral between these professions and Chiropractors.