Accardi Caterina, Cerritelli Francesco, Bovo Lorenza, Esteves Jorge E
Foundation COME Collaboration, Clinical-Based Human Research Department, Pescara, Italy.
Malta ICOM Educational Ltd., Gzira, Malta.
Front Psychol. 2023 Oct 2;14:1253355. doi: 10.3389/fpsyg.2023.1253355. eCollection 2023.
Enactivism and active inference are two important concepts in the field of osteopathy. While enactivism emphasizes the role of the body and the environment in shaping our experiences and understanding of the world, active inference emphasizes the role of action and perception in shaping our experiences and understanding of the world. Together, these frameworks provide a unique perspective on the practice of osteopathy, and how it can be used to facilitate positive change in patients. Since the neonatal period is a crucial time for development, osteopaths should aim to create a therapeutic relationship. Arguably, through participatory sense-making, osteopaths can help the baby build a generative model (with positive priors) to deal with stress and needs throughout their life.
Since the literature considers that interactions with the environment, which enact the patients' experiences, depending on contextual factors and communication between patient and caregiver, this research explored whether there is a correspondence between the indications in the literature and clinical practice in the management of the mother/parent-child dyad during osteopathic care on children aged 0 to 2 years old.
Semi-structured interviews were conducted with a purposive sample of nine osteopaths with experience in the field of pediatrics. Interviews were transcribed verbatim, and constructivist grounded theory was used to conceptualize, collect and analyze data. Codes and categories were actively constructed through an interpretive/constructionist paradigm.
The core category was the idea of the pediatric osteopath as a support for the family, not only for the child. Four additional categories were identified: (1) Preparing a safe environment for both children and parents, (2) Communication, (3) Attachment and synchrony, and (4) Synchronization.
Through participatory sense-making, osteopaths manage contextual factors to establish an effective therapeutic alliance through the osteopath-parent-child triad to facilitate the construction of the child's internal generative model to promote healthy development. The therapeutic encounter is considered an encounter between embodied subjects, occurring within a field of affordances (ecological niche) that allows the interlocutors to actively participate in creating new meanings through interpersonal synchronization. Participatory sense-making and the establishment of a therapeutic alliance through the osteopath-parent-child triad are crucial to promote healthy development in the child.
具身认知论和主动推理是整骨疗法领域的两个重要概念。具身认知论强调身体和环境在塑造我们对世界的体验和理解中的作用，而主动推理则强调行动和感知在塑造我们对世界的体验和理解中的作用。这些框架共同为整骨疗法的实践以及如何利用它促进患者的积极改变提供了独特的视角。由于新生儿期是发育的关键时期，整骨疗法医生应致力于建立治疗关系。可以说，通过参与性意义建构，整骨疗法医生可以帮助婴儿建立一个生成模型（具有积极的先验知识），以应对其一生中的压力和需求。
鉴于文献认为与环境的互动会根据情境因素以及患者与照顾者之间的沟通来塑造患者的体验，本研究探讨了在对0至2岁儿童进行整骨疗法护理期间，文献中的指征与母婴/亲子二元组管理中的临床实践之间是否存在对应关系。
对九名具有儿科领域经验的整骨疗法医生进行了目的性抽样的半结构化访谈。访谈逐字记录，并采用建构主义扎根理论对数据进行概念化、收集和分析。代码和类别通过解释性/建构主义范式积极构建。
核心类别是儿科整骨疗法医生作为家庭支持的理念，而不仅仅是对孩子的支持。还确定了另外四个类别：（1）为儿童和父母准备一个安全的环境，（2）沟通，（3）依恋和同步性，以及（4）同步。
通过参与性意义建构，整骨疗法医生管理情境因素，通过整骨疗法医生 - 父母 - 孩子三元组建立有效的治疗联盟，以促进儿童内部生成模型的构建，从而促进健康发展。治疗性接触被视为具身主体之间的接触，发生在一个可供性的场域（生态位）中，这使得对话者能够通过人际同步积极参与创造新的意义。通过整骨疗法医生 - 父母 - 孩子三元组进行参与性意义建构和建立治疗联盟对于促进儿童的健康发展至关重要。
