What are the factors that guide an osteopath during the process of technique choice?
Permanent link to Research Bank record:http://hdl.handle.net/10652/1935
Osteopathy offers a method of treating dysfunction in the body that is drug and surgery free. The osteopathic practitioner applies his knowledge of anatomy and physiology to the condition of each patient he is presented with, in order to choose the most appropriate manual technique, which will best bring about a state of health. The osteopath must choose from an extremely wide range of osteopathic techniques available, even though the outcome from many techniques will be essentially the same. Factors that may influence this decision, if understood, may assist in this decision-making process. As the factors influencing osteopaths during their technique choices is an under-researched topic, this was the subject chosen for exploration in the research study presented here. To determine the factors influencing osteopathic technique choice, a qualitative, interpretive description study design was employed so that themes relating to this under-researched topic could be defined and explored. Participants were recruited by the use of purposive sampling, six osteopaths with varying osteopathic experience were selected, three of these male and three female. Exploratory, in-depth interviews were conducted with each of these osteopaths, so that transcript data could then be thematically analysed using the interpretive description method. After extensive analysis of the interview transcripts three main themes emerged; technique choice was shown to be the result of patient, practitioner, or outcome-based factors. Patient-based factors include those clues and signs gained from the practitioner’s osteopathic physical examination and case history, pertaining to each patient; and those that were influenced by any intuitive impression, or knowing, that the osteopath may receive from their patient. Practitioner-based factors describe decisions made in response to the practitioner’s personal values, philosophies, beliefs, goals and morphology. Outcome-based decisions were those made because the practitioner had an expectation of their therapeutic outcome. Through experience osteopaths subconsciously or consciously create their own repertoire of techniques. The discussion was aimed towards deeper understanding of technique choice and of the journey osteopath’s travel, as their experience increases. The use of intuition in osteopathic decision-making is discussed, as is the effect practitioner’s individuality has on their eventual choices. The use of intuition in clinical decision-making is controversial, so the osteopathic community may learn to be reflective practitioners, in order that they may better understand each intuitive choice. As experience, knowledge, recognition of self, osteopathic skills and the use of intuition increase and are recognised, each osteopath becomes a confident expert, who may make a confident decision when choosing the most appropriate technique for each situation. Knowledge and understanding of the factors responsible for technique choice therefore has the potential to benefit the osteopathic community as whole.