Thomson Oliver P, Petty Nicola J, Moore Ann P
Clinical Research Centre for Health Professions, School of Health Professions, University of Brighton, Darley Road, Eastbourne, UK; Research Department, The British College of Osteopathic Medicine, Lief House, Finchley Road, London, UK; Research Centre, The British School of Osteopathy, 275 Borough High Street, London, UK.
Clinical Research Centre for Health Professions, School of Health Professions, University of Brighton, Darley Road, Eastbourne, UK.
Man Ther. 2014 Feb;19(1):37-43. doi: 10.1016/j.math.2013.06.005. Epub 2013 Aug 2.
How practitioners conceive clinical practice influences many aspects of their clinical work including how they view knowledge, clinical decision-making, and their actions. Osteopaths have relied upon the philosophical and theoretical foundations upon which the profession was built to guide clinical practice. However, it is currently unknown how osteopaths conceive clinical practice, and how these conceptions develop and influence their clinical work. This paper reports the conceptions of practice of experienced osteopaths in the UK. A constructivist grounded theory approach was taken in this study. The constant comparative method of analysis was used to code and analyse data. Purposive sampling was employed to initially select participants. Subsequent theoretical sampling, informed by data analysis, allowed specific participants to be sampled. Data collection methods involved semi-structured interviews and non-participant observation of practitioners during a patient appointment, which was video-recorded and followed by a video-prompted reflective interview. Participants' conception of practice lay on a continuum, from technical rationality to professional artistry and the development of which was influenced by their educational experience, view of health and disease, epistemology of practice knowledge, theory-practice relationship and their perceived therapeutic role. The findings from this study provide the first theoretical insight of osteopaths' conceptions of clinical practice and the factors which influence such conceptions.
从业者如何构想临床实践会影响其临床工作的许多方面，包括他们对知识的看法、临床决策以及他们的行为。整骨疗法师依靠该专业建立的哲学和理论基础来指导临床实践。然而，目前尚不清楚整骨疗法师如何构想临床实践，以及这些构想如何发展并影响他们的临床工作。本文报告了英国经验丰富的整骨疗法师的实践构想。本研究采用了建构主义扎根理论方法。使用持续比较分析法对数据进行编码和分析。最初采用目的抽样法选择参与者。随后，在数据分析的指导下进行理论抽样，以便对特定参与者进行抽样。数据收集方法包括半结构化访谈以及在患者预约期间对从业者进行非参与式观察，观察过程进行了视频记录，并在之后进行视频引导的反思性访谈。参与者的实践构想处于一个连续体上，从技术合理性到专业技艺，其发展受到他们的教育经历、对健康和疾病的看法、实践知识的认识论、理论与实践的关系以及他们所感知的治疗角色的影响。本研究结果首次提供了关于整骨疗法师临床实践构想以及影响这些构想的因素的理论见解。
