Gíslason Halldór Fannar, Salminen Jari Kullervo, Sandhaugen Linn, Storbråten Andreas Stenseth, Versloot Renske, Roug Inger, Newell Dave
Reykjavik, Iceland.
Tampere, Finland.
Chiropr Man Therap. 2019 Apr 10;27:16. doi: 10.1186/s12998-019-0237-z. eCollection 2019.
The chiropractic profession both in the past and presently has diverse opinions concerning different health care approaches and the science or otherwise that underpins them. Previous research has reported that adherence to unorthodox descriptions of chiropractic were associated with types of practice behavior considered outside of acceptable evidence-based guidelines in Canada. However, this type of investigation has not been repeated in a European context and such relationships may be different.
A survey was disseminated amongst European chiropractors during early 2017. Dissemination was through an on-line platform with links to the survey being sent to all European chiropractic associations regardless of European Chiropractors' Union (ECU) membership and additionally through the European Academy of Chiropractic (EAC). Social media via Facebook groups was also used to disseminate links to the survey.
One thousand three hundred twenty and two responses from chiropractors across Europe representing approximately 17.2% of the profession were collected. Five initial self-determined chiropractic identities were collapsed into 2 groups categorised as orthodox (79.9%) and unorthodox (20.1%). Analysis of responses to a range of questions stratified by such groups was carried out. When comparing the percentage of new patients chiropractors x-rayed, 23% of the unorthodox group x-rayed > 50% of their new patients compared to 5% in the orthodox group. Furthermore, the proportion of respondents reporting > 150 patient encounters per week in the unorthodox group were double compared to the orthodox (22 v 11%). Lastly the proportion of those respondents disagreeing or strongly disagreeing with the statement was 57 and 4% in unorthodox and orthodox categories respectively. Logistic regression models identified male gender, seeing more than 150 patients per week, no routine differential diagnosis, and not strongly agreeing that vaccines have generally had a positive impact on health as highly predictive of unorthodox categorisation.
Despite limitations with generalisability in this survey, the proportion of respondents adhering to the different belief categories are remarkably similar to other studies exploring this phenomenon. In addition, and in parallel with other research, this survey suggests that key practice characteristics in contravention of national radiation guidelines or opposition to evidence based public health policy are significantly more associated with non-orthodox chiropractic paradigms.
过去和现在，整脊疗法行业对于不同的医疗保健方法以及支撑这些方法的科学依据或其他依据都存在不同观点。先前的研究报告称，在加拿大，坚持非正统的整脊疗法描述与被认为超出可接受的循证指南范围的执业行为类型有关。然而，此类调查在欧洲尚未重复进行，而且这种关系可能有所不同。
2017年初在欧洲整脊疗法师中开展了一项调查。通过在线平台进行传播，调查链接被发送给所有欧洲整脊疗法协会，无论其是否为欧洲整脊疗法师联盟（ECU）成员，此外还通过欧洲整脊疗法学院（EAC）进行传播。还利用脸书群组等社交媒体来传播调查链接。
共收集到来自欧洲各地整脊疗法师的1322份回复，约占该行业的17.2%。最初自行确定的五种整脊疗法身份被归为两类，即正统（79.9%）和非正统（20.1%）。对按此类分组的一系列问题的回复进行了分析。在比较整脊疗法师为新患者进行X光检查的比例时，非正统组中有23%的人对超过50%的新患者进行了X光检查，而正统组这一比例为5%。此外，非正统组中报告每周接诊患者超过150例的受访者比例是正统组的两倍（22%对11%）。最后，对于该陈述表示不同意或强烈不同意的受访者比例，非正统组和正统组分别为57%和4%。逻辑回归模型确定，男性、每周接诊患者超过150例、无常规鉴别诊断以及不太认同疫苗总体上对健康有积极影响等因素高度预测非正统分类。
尽管本次调查在普遍性方面存在局限性，但坚持不同信念类别的受访者比例与探索这一现象的其他研究非常相似。此外，与其他研究一样，本次调查表明，违反国家辐射指南或反对循证公共卫生政策的关键执业特征与非正统整脊疗法范式的关联更为显著。
