Exploring the approaches used by New Zealand osteopaths to help promote exercise rehabilitation adherence

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Authors
Whitford, Patrick
Author ORCID Profiles (clickable)
Degree
Master of Osteopathy
Grantor
Unitec, Te Pūkenga - New Zealand Institute of Skills and Technology
Date
2023
Supervisors
Williden, Micalla
Verhoeff, Wesley
Type
Masters Thesis
Ngā Upoko Tukutuku (Māori subject headings)
Keyword
New Zealand
osteopaths and patients
active engagement
osteopathic medicine
exercise adherence
rehabilitative exercise
surveys
Citation
Whitford, P. (2023) Exploring the approaches used by New Zealand osteopaths to help promote exercise rehabilitation adherence (Unpublished document submitted in partial fulfilment of the requirements for the degree of Master of Osteopathy). Unitec, Te Pūkenga – New Zealand Institute of Skills and Technology https://hdl.handle.net/10652/6290
Abstract
BACKGROUND Patient adherence to exercise rehabilitation is pertinent to the successful recovery from musculoskeletal injury. However, exercise rehabilitation adherence is a significant and multidimensional issue within New Zealand osteopathy and other manual therapy professions, impacting on patient outcomes. Behaviour change theory and techniques have been shown to increase patient adherence to physical activity advice and exercise prescription which positively impacts on patients quality of life, reduced risk of chronic disease, and overall function. The purpose of this study was to explore the behaviour change approaches used by New Zealand (NZ) osteopaths and to uncover potential recommendations to the NZ osteopathic curriculum for the integration of behaviour change to promote adherence to exercise rehabilitation programmes. METHODS This study used semi-structured interviews to gather descriptive data from seven registered NZ osteopaths who regularly use exercise prescription in their practice. Thematic analysis was used to draw rich themes from the qualitative data set. RESULTS This study provided an understanding of NZ osteopaths' experiences with exercise prescription, barriers and enablers towards patient adherence, an insight into the osteopathic curricula regarding exercise prescription, and participants knowledge around behaviour change theory and techniques. Five themes were identified from the final data analysis: (1) Participants knowledge of behaviour change theory and strategies, (2) contributing factors towards NZ osteopaths prescribing exercise rehabilitation, (3) adherence to exercise rehabilitation programmes is an issue within NZ osteopathy, (4) participants thoughts on behaviour change in the osteopathic curriculum and recommendations, and (5) factor influencing patient adherence. Participants knowledge of behaviour change theory and strategies is developed during practical experience via the culmination of exposure, application, self-reflection, and the development of expert knowledge, CONCLUSION The findings demonstrated that participants of this study hold positive attitudes toward exercise prescription within their osteopathic practice. The development of expert knowledge through years of clinical experience allows NZ osteopaths to become aware of the barriers and enablers that contribute to patient adherence to physical activity advice and exercise rehabilitation. With this, osteopaths can develop an unconscious application of behaviour change models and behaviour change strategies learnt through their clinical experiences and exposure to bouts of non-adherence. Participants agree that behaviour change theory and/or strategies has a place within the NZ osteopathic curriculum, however, it is unclear where it may fit due to the prioritisation of graduate competency and safe practice.
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