Osteopaths’ attitudes, knowledge and practice approaches regarding obesity

Abstract

RESEARCH QUESTION: Is there a relationship between the knowledge of and attitudes towards obesity in New Zealand and Australian osteopaths?

BACKGROUND. Obesity is a serious condition that is considered a precursor to several morbidities, including systemic cardiovascular disease, type-2 diabetes, certain cancers and is recognised as having detrimental effects on the musculoskeletal system in the form of early onset osteoarthritis, rheumatoid arthritis, gout, low back pain, osteoporosis, fibromyalgia, carpal tunnel syndrome and plantar fasciitis. Obesity affects one third of New Zealand adults and one in eight children and is continuing to rise. Healthcare professionals are at the forefront of obesity management and research investigating the management and treatment approaches of healthcare professionals is needed if we are to understand obesity and successfully conclude its continued growth in society. There is limited research investigating physical therapists’ attitudes, knowledge and practice approaches regarding obesity and even less is known about the attitude, knowledge and practice approaches of osteopaths.

AIMS. To ascertain the level of knowledge osteopaths’, have on obesity, measure their attitudes regarding obese individuals to determine the extent of obesity stigma and lastly to record what advice osteopaths provide when making recommendations to obese patients.

STUDY DESIGN AND METHODS: A cross-sectional survey was completed by participants (n=95) via the web-based survey provider ‘survey monkey’. The survey was designed to take no more than 20 minutes inclusive of reading the information page and was modelled on previously published and validated questionnaires utilised in similar research examining attitudes towards, knowledge of and practice approaches to obesity of physician and physiotherapist cohorts. Items were adapted for use in the New Zealand and Australian osteopathic professions. Data was cleaned and sorted in Microsoft Excel before being analysed with SPSS statistical software. The majority of data tested as non-parametric, resulting in Tau and Spearman rank-order being the most suitable analysis method. Correlations were run between the main variables, including practitioner knowledge, attitudes, recommendations (practice approaches), practitioner BMI, number of patients and practitioner exercise amount per week.

RESULTS. Overall osteopaths rated ‘overeating’ (97.9%), ‘physical inactivity’ (95.7%), ‘psychological problems’ (95.7%) and ‘poor knowledge about nutrition’ (94.7%) as the most common factors leading to obesity. Osteopaths’ had average knowledge of obesity scoring 4.5/10 and rated ‘exercising more’ (68.8%) as the most common intervention they recommend to obese patients. On average, respondents showed mildly positive attitude toward obese patients. Out of a maximum positive score of 7 for attitude, osteopaths scored 4.3 (SD=0.6). All variables were analysed with SPSS statistical software, the following relationships were identified. A moderate positive Pearson correlation between ‘appointment length’ and positive ‘attitude’ scores was observed in the Australian cohort but not the New Zealand cohort, (rp = .439, p = .004). A positive Spearman correlation was identified between participant’s ‘BMI’ and their individual ‘attitudes’ regarding statements about obesity for the Australian cohort (rs = .354, p = .025).

CONCLUSIONS. The present findings indicate that, on average, osteopaths’ have mildly positive attitudes regarding obese patients and that this positive attitude, consistent with current literature was independent of all variables, for example, obesity knowledge, practitioner recommendations and appointment length. Consistent with studies examining practice approaches to obesity of physical therapists, osteopaths from the current study most