Abstract
Background: Chiropractic is a health profession regarding the prevention, diagnosis, and treatment of
mechanical disorders of the musculoskeletal system and chiropractors are regarded as primary spine
care providers. The biomedical model has been the primary route in treatment for as long as medical
science existed. It is centred around biological causes for disability and aims at preventing patients at
risk of developing particular diseases. The biopsychosocial model was first conceptualised by George
Engel in 1977 and aims to address psychological and social factors that contribute to physical ailments.
A primary study was conducted on chiropractors in various provinces of South Africa, to determine
attitudes and beliefs regarding their treatment approach. However, there has been no research done on
this topic in relation to the largest sample sizes based on the previous research.
Aim: The aim of this secondary analysis was to explore the attitudes and beliefs of chiropractors practicing
in Gauteng, KwaZulu-Natal, and the Western Cape regarding their approach to treatment. A secondary
aim was to determine demographic variables such as gender or educational institution.
Method: This secondary analysis was conducted with the assistance of a statistician at STATKON and
used the following statistical analysis: frequencies and descriptive statistics, reliabilities (Cronbach’s
alpha) on the pain and attitude belief scale, descriptive statistics on scales/scores and normality, and
comparisons to compare demographics on the scores/scales. As there were more than fifty responses
per group, the normality test used was the Kolmogorov–Smirnov test. For the comparisons between
Gauteng, KwaZuluNatal and the Western Cape, the independent samples-t-test and analysis of variance
(ANOVA) testing was done. For the comparisons of gender and educational institutions, the independent
samples-t-test was done.
Results: Out of 524 qualified and registered chiropractors practicing in the years between 2020 and 2021,
a total of 264 responses were obtained. Therefore, the response rate for this secondary analysis was
50.4%.
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Of the 264 participants, 124 (47%) were based in Gauteng (G), 74 (28%) were in KwaZulu-Natal (KZN)
and 66 (25%) were based in the Western Cape (WC) provinces. The p-values for the BPS and BM were
not found to be statically significant, p=0.639 and p=0.057 respectively.
Therefore, it is interpreted that all three provinces view the BM and BPS subscales with similar attitudes
and beliefs.
Based on the survey results, 111 (42%) of the respondents were male and 153 (58%) of the respondents
were female. The values showed that there was no statistically significant difference between males (BM
p-value: 0.017; BPS p-value: 0.038) and females (BM p-value: 0.000; BPS p-value: 0.009) for BM and
BPS scores. It was concluded that of the 248 participants who received their degree in South Africa, 134
(54%) received their education from the University of Johannesburg (UJ) and Technikon Witwatersrand,
and 114 (46%) received their education from the Durban University of Technology (DUT) and Technikon
Natal. The statistics show that there is no statistical difference between educational institutions for BM
and BPS scores, indicating that although there are minor differences in the educational curriculums of
the two institutions, the students still receive similar education regarding their treatment approach.
Conclusion: This secondary analysis concluded that all three provinces view the BM and BPS subscales
with similar attitudes and beliefs, the results of the secondary aims revealed no statistically significant
difference between males and females or between educational institutions for BM and BPS scores,
therefore, both males and females as well as educational institutions view the BM and BPS subscales
with similar attitudes and beliefs.