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.

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.

Thesis (DPhil)--University of Stellenbosch, 2005. / 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. / AFRIKAANSE OPSOMMING: Alhoewel chiropraktyk ’n geoorloofde verskaffer van manipulasieterapie is, funksioneer dit grootliks buite hoofstroomgesondheidsorg in Suid-Afrika. ’n Eng navorsingsfokus, swak institusionele verteenwoordiging en ontoereikende professionele integrasie het tot die onbepaalde rol van chiropraktyk in gesondheidsorg bygedra. Hierdie verkennende kwalitatiewe studie het gepoog om chiropraktiese praktyk ten opsigte van oortuiginge, filosofie, navorsingsmetodes en kliniese praktyke te ondersoek. Semi-gestruktureerde onderhoude is gebruik om response van tien chiropraktisyns, ses pasiënte en vier navorsers te verkry. Die uitslae is op drie vlakke geïnterpreteer: (i) tematies; (ii) met betrekking tot die chiropraktiese dissipline en beroep; en (iii) as ’n funksie van die “drie wêrelde”-raamwerk. Die tematiese analise het die volgende blootgelê: 1. Oortuiginge en filosofiese tradisies speel ’n aktiewe rol in die praktyk en wetenskap van chiropraktyk. 2. Die chiropraktiese ondersoekende paradigma is besig om verder te ontwikkel. 3. Die kontekstuele rol van navorsingsmetodes word duideliker gemaak. 4. Hedendaagse chiropraktiese praktyk is nie soveel op bewyse gegrond as wat dit behoort te wees nie. 5. Die chiropraktiese model van praktyk verskil aansienlik van die aanvaarde standaard- mediese model. 6. Die identiteit van chiropraktiese kliniese praktyk is vaag. 7. Chiropraktyk se professionele status is onduidelik. 8. Die professionele en dissiplinêre komponente van chiropraktyk is steeds institusioneel onderontwikkel. 9. Die legitimiteit van chiropraktyk is betwisbaar. Temas 1 tot 3 het daarop gedui dat oortuiginge en filosofiese tradisies die wyses beïnvloed waarop chiropraktisyns klinies handel, waarop pasiënte die wêreld van gesondheidsorg sien, en waarop navorsers kliniese verskynsels bestudeer. Uit temas 4 tot 6 kan afgelei word dat chiropraktiese kliniese praktyk van geneeskunde verskil; die presiese aard van die praktykmodel kom egter heel onbestendig voor. Uit temas 7, 8 en 9 kan afgelei word dat die graad van professionele en institusionele ontwikkeling chiropraktyk slegs gedeeltelik legitimeer.