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   <dc:title>Chiropractic students’ perception and practice of patient education on management of musculoskeletal conditions at a tertiary education teaching clinic</dc:title>
   <dc:creator>Nieuwenhuis, Hardus</dc:creator>
   <dc:contributor>Maharaj, Praveena</dc:contributor>
   <dc:contributor>Korporaal, Charmaine Maria</dc:contributor>
   <dc:subject>Chiropractic students</dc:subject>
   <dc:subject>Patient education</dc:subject>
   <dc:subject>Musculoskeletal system</dc:subject>
   <dc:subject>Chiropractic</dc:subject>
   <dc:subject>Health occupations students--Attitudes</dc:subject>
   <dc:subject>Chiropractic clinics--South Africa</dc:subject>
   <dc:subject>Patient education</dc:subject>
   <dc:description>Dissertation submitted in partial compliance with the requirements for the Master’s Degree in Technology: Chiropractic at the Durban University of Technology, Durban, South Africa, 2022.</dc:description>
   <dc:description>Background&#xd;
Modern healthcare is characterised by patient-centred care, which requires that healthcare&#xd;
professionals have equal proficiency in communication and practical skills. As part of their&#xd;
duty as healthcare professionals, chiropractors must show patients how to help themselves&#xd;
through patient education, which requires communication skills. Patient education no longer&#xd;
solely involves or refers to knowledge transfer alone, but rather working with patients in their&#xd;
specific context to build knowledge together from a partnership perspective and to share&#xd;
power in this dynamic. From this perspective, patient education becomes a tool to empower&#xd;
patients and improve their self-efficacy and coping habits, without constantly relying on&#xd;
passive care. This study presents a detailed evaluation of patient education within a South&#xd;
African chiropractic student context at the Durban University of Technology.&#xd;
Aims and Objectives&#xd;
This study aimed to describe chiropractic students’ perceptions and practice of patient&#xd;
education of musculoskeletal conditions at a teaching clinic. The objectives were to evaluate&#xd;
the students’ perception of patient education and the strategies they use; their self-reported&#xd;
practice of patient education; barriers that students face when educating patients; factors&#xd;
that contribute to their patient education skills development, and to determine whether there&#xd;
is an association between demographics, their perception and practice.&#xd;
Methods&#xd;
The study was an anonymous web-based questionnaire with a cross-sectional design within&#xd;
a quantitative paradigm. The survey used in this study stems from a physiotherapist study.&#xd;
Permission was obtained from the author to replicate the study in a South African context&#xd;
at the Durban University of Technology Chiropractic Day Clinic (DUT CDC). The original&#xd;
survey was then put through a focus group and pilot study and subsequently adapted to&#xd;
include questions related explicitly to chiropractic and the student population at the Durban&#xd;
University of Technology. Weekly reminders were sent via email to class representatives to&#xd;
distribute among their respective classes. A total of 42 completed questionnaires were used&#xd;
for analysis in this study.&#xd;
Cronbach’s alpha was used to assess internal consistency of scales. The scale scores were&#xd;
computed by averaging the 18 items for Question 6 and Question 5 respectively where Ttests were used to compare these scores between the demographic variables for binary&#xd;
data, ANOVA for ordinal data and Pearson’s correlation analysis, where the demographic variable was quantitative and normally distributed. A Wilcoxon signed ranks test was used&#xd;
for the comparison of time spent on patient education at initial consults and time spent on&#xd;
patient education at follow-up consults&#xd;
Results&#xd;
Overall, the students viewed most of the patient education items to be important and should&#xd;
be discussed with patients. In practice, however, the frequency of their practice did not&#xd;
correspond to the perceived importance. Only a few items were practised to the same extent&#xd;
as the perceived importance thereof. The chiropractic students’ discussions with their&#xd;
patients tend to focus on the main complaint of patients. In most cases, students educate&#xd;
their patients through one-on-one discussions, physical demonstration and anatomy&#xd;
models. During initial visits, students usually spend between 6–15 minutes educating their&#xd;
patients; in follow-up visits, the time is reduced to 6–10 minutes. In most cases, students&#xd;
cited patient characteristics as a barrier to effective patient education. For the chiropractic&#xd;
students, developing their patient education skills was largely dependent on their&#xd;
interactions with supervising clinicians. There was no association between demographics,&#xd;
perceived importance, and practice behaviour in this study.&#xd;
Conclusion&#xd;
Although the patient education topics were generally deemed important by chiropractic&#xd;
students, the topics considered most important are directly related to the main complaints&#xd;
of their patients, with more complex topics not being perceived as necessary as those&#xd;
directly related to the complaint, such as diagnosis. Like their perceptions, the students&#xd;
most frequently addressed the topics they deemed important; thus, their perceptions and&#xd;
practice were congruent (for issues related to the main complaint of the patients). An&#xd;
important finding of this study was that, although DUT follows an evidence-based paradigm,&#xd;
many students perceived pathoanatomical explanations to be important and, thus, provided&#xd;
their patients with such explanations, even though the literature does not support it. In&#xd;
addition, the students reported several methods through which they educate their patients.&#xd;
However, the assessment of whether it was successful was mainly centred around physical&#xd;
activity rather than the patients’ understanding of the information discussed. The results&#xd;
indicate an opportunity to improve the patient education skills of students, as they appear&#xd;
to have difficulty adjusting to difficult situations, and thereby perceive factors to be barriers&#xd;
that are not actual barriers but rather challenges.</dc:description>
   <dc:description>M</dc:description>
   <dc:date>2023-08-03T06:11:14Z</dc:date>
   <dc:date>2023-08-03T06:11:14Z</dc:date>
   <dc:date>2023-05-31</dc:date>
   <dc:type>Thesis</dc:type>
   <dc:identifier>https://hdl.handle.net/10321/4913</dc:identifier>
   <dc:identifier>https://doi.org/10.51415/10321/4913</dc:identifier>
   <dc:language>en</dc:language>
   <dc:format>234 p</dc:format>
   <dc:format>application/pdf</dc:format>
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