Department of Neurosurgery, Medical College of Wisconsin, Milwaukee, WI, USA.
University of Bridgeport, College of Health Sciences, School of Chiropractic, Bridgeport, CT, USA.
BMC Health Serv Res. 2021 Oct 5;21(1):1049. doi: 10.1186/s12913-021-07081-0.
Professional subgroups are common and may play a role in aiding professional maturity or impeding professional legitimization. The chiropractic profession in the United States has a long history of diverse intra-professional subgroups with varying ideologies and practice styles. To our knowledge, large-scale quantification of chiropractic professional subgroups in the United States has not been conducted. The purpose of this study was to quantify and describe the clinical practice beliefs and behaviors associated with United States chiropractic subgroups.
A 10% random sample of United States licensed chiropractors (n = 8975) was selected from all 50 state regulatory board lists and invited to participate in a survey. The survey consisted of a 7-item questionnaire; 6 items were associated with chiropractic ideological and practice characteristics and 1 item was related to the self-identified role of chiropractic in the healthcare system which was utilized as the dependent variable to identify chiropractic subgroups. Multinomial logistic regression with predictive margins was used to analyze which responses to the 6 ideology and practice characteristic items were predictive of chiropractic subgroups.
A total of 3538 responses were collected (39.4% response rate). Respondents self-identified into three distinct subgroups based on the perceived role of the chiropractic profession in the greater healthcare system: 56.8% were spine/neuromusculoskeletal focused; 22.0% were primary care focused; and 21.2% were vertebral subluxation focused. Patterns of responses to the 6 ideologies and practice characteristic items were substantially different across the three professional subgroups.
Respondents self-identified into one of three distinct intra-professional subgroups. These subgroups can be differentiated along themes related to clinical practice beliefs and behaviors.
专业分组很常见，可能有助于促进专业成熟，也可能阻碍专业合法化。美国的整脊行业有着悠久的历史，存在着不同意识形态和实践风格的多样化内部专业分组。据我们所知，美国整脊行业的大规模专业分组量化尚未进行。本研究的目的是量化和描述与美国整脊分组相关的临床实践信念和行为。
从所有 50 个州的监管委员会名单中抽取美国持照整脊师的 10%随机样本（n=8975），邀请他们参与一项调查。该调查由一个 7 项问卷组成；其中 6 项与整脊意识形态和实践特征有关，1 项与整脊在医疗保健系统中的自我认同角色有关，该角色被用作识别整脊分组的因变量。采用多分类逻辑回归与预测边际分析来分析对 6 项意识形态和实践特征项目的哪些回答可以预测整脊分组。
共收集到 3538 份回复（39.4%的回复率）。受访者根据整脊专业在更大的医疗保健系统中的感知角色，将自己分为三个不同的分组：56.8%专注于脊柱/神经肌肉骨骼；22.0%专注于初级保健；21.2%专注于脊椎小关节错位。对 6 项意识形态和实践特征项目的回答模式在三个专业分组之间存在显著差异。
受访者自我认同为三个不同的内部专业分组之一。这些分组可以根据与临床实践信念和行为相关的主题进行区分。
