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Exploration of the characteristics of German osteopaths and osteopathic physicians: survey development and implementation

Journal: Unpublished PhD thesis University of Bedfordshire, Date: 2019/01, Pages: 930, type of study: cross sectional study

Free full text   (https://uobrep.openrepository.com/handle/10547/623987)

Keywords:

cross sectional study [597]
Germany [121]
osteopaths [138]

Abstract:

Background Osteopathy and its practice in Germany is unregulated without nationally agreed competencies, frameworks or practice standards. The heterogeneity of practice makes it likely that there is a great variety in the nature and scope of practice. Educational programs vary greatly in length and content and no nationally agreed curriculum exists. The high number of osteopathic associations with varying political goals and perspectives suggests a fragmentation of the osteopathic community. Little formal research has been reported on standards and practice of osteopathic care in Germany. The lack of data contributes to uncertainty and makes it difficult to build a case for a more united regulated profession. ii. Purpose A series of connected studies aimed to develop an instrument to survey the osteopathic profession in Germany. The purpose was to obtain data about the characteristics of the osteopaths and osteopathic physicians and their practice in order to provide a coherent picture of the profession in Germany. iii. Methods A scoping review and appraisal of cross-sectional studies was conducted to create an overview of the literature from cross-sectional studies in the field and to identify possible survey tools usable in the German context. This phase led to the decision to develop a survey instrument specifically for the German environment which was informed by the results of the scoping review. Previous questionnaires informed the first draft of the questionnaire. Mixed methods enhanced the design of the questionnaire utilising a consensus group, cognitive interviews with stakeholders, expert rating and feedback methodologies with participants nominated by national associations. After a final online pilot test the survey was implemented in a national cross-sectional survey with the participants recruited from eight national associations. Invitations were disseminated by the associations with 2 follow-up reminders. Data were collected using the SmartSurvey® online questionnaire system. iv. Results The validated questionnaire consisted of 55 items subdivided into 8 sections and was used in a cross-sectional study with a sample group of 8,331 osteopaths and osteopathic physicians from November 2017 to February 2018. The response rate was 18.9% (n=1578), from which 1,175 were active practicing respondents who had complete data sets. Osteopaths and osteopathic physicians in Germany provide osteopathic care for a wide range of patient age groups presenting with various complaints and conditions using a variety on methods and techniques. Some differences were observed between German practice nationally and practice internationally. v. Conclusions Cross-sectional studies of osteopathic practice are commonly poorly reported and many are weak methodologically. A newly validated questionnaire has provided data on the nature of practice in Germany. There is some variability in practice between and within stakeholder osteopathic groups in Germany. There is a need for unification of the osteopathic groups and regulation to improve professional identity and to support the implementation of nationally agreed standards of practice, education and safety.


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