Centre for Chiropractic Research, New Zealand College of Chiropractic, Auckland, New Zealand.
Department of Psychology, Auckland University of Technology, Auckland, New Zealand.
Complement Ther Clin Pract. 2020 May;39:101105. doi: 10.1016/j.ctcp.2020.101105. Epub 2020 Jan 23.
Since the inception of the chiropractic profession, debate has continued on differing practice objectives and philosophical approaches to patient care. While the political and academic leaders of the profession continue to dominate the discourse, little is known on the perspectives of the everyday practising chiropractor on their professional identity. In this paper, professional identity within the profession of chiropractic was evaluated using a systematised search strategy of the literature from the year 2000 through to May 2019. Initially 562 articles were sourced, of which 24 met the criteria for review. The review confirmed three previously stated professional identity subgroups; two polarised approaches and a centrist or mixed view. The musculoskeletal biomedical approach is in contrast to the vertebral subluxation vitalistic practice approach. Whilst these three main chiropractic identity subtypes exist, within the literature the terminology used to describe them differs. Research aimed at categorising the chiropractic profession identity into exclusive subtypes found that at least 20% of chiropractors have an exclusive vertebral subluxation focus. However, deeper exploration of the literature shows that vertebral subluxation is an important practice consideration for up to 70% of chiropractors. Patient care with a musculoskeletal spine focus is dominant in clinical practice. This review found that practising chiropractors consider themselves to be primary care or primary contact practitioners with a broad scope of practice across a number of patient groups not limited to musculoskeletal management. Across the research, there is a marked difference in the categories of practice objectives evaluated, and future research could examine the relatedness of these. Additionally, future research could explore the professional identity construct over time and within different practice contexts to help facilitate the progression of the profession.
自整脊专业成立以来，关于不同的实践目标和哲学方法的争论一直在持续。虽然该专业的政治和学术领袖继续主导着讨论，但对于日常执业整脊医师对其专业身份的看法却知之甚少。在本文中，我们使用系统的文献搜索策略，评估了整脊专业中的专业身份，该策略的搜索范围为 2000 年至 2019 年 5 月的文献。最初，共检索到 562 篇文章，其中 24 篇符合审查标准。该综述证实了之前提到的三个专业身份亚组；两种两极分化的方法和一种中间或混合的观点。骨骼肌肉生物医学方法与椎骨错位的生命活力实践方法形成对比。虽然存在这三个主要的整脊身份亚组，但在文献中，用于描述它们的术语不同。旨在将整脊专业身份分类为排他性亚组的研究发现，至少有 20%的整脊医师具有排他性的椎骨错位焦点。然而，对文献的更深入探讨表明，对多达 70%的整脊医师来说，椎骨错位是一个重要的实践考虑因素。以骨骼肌肉脊柱为重点的患者护理在临床实践中占主导地位。本综述发现，执业整脊医师认为自己是初级保健或初级接触医师，具有广泛的实践范围，涵盖了许多患者群体，不仅限于骨骼肌肉管理。在整个研究中，评估的实践目标类别存在明显差异，未来的研究可以检查这些类别的相关性。此外，未来的研究可以探索随着时间的推移和在不同实践环境中的专业身份结构，以帮助促进该专业的发展。
