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      Drivers, barriers, and response to care of Australian pregnant women seeking chiropractic care for low back and pelvic girdle pain: a qualitative case study

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          Abstract

          Background

          Pregnancy-related low back and/or pelvic girdle pain is common, with a prevalence rate of up to 86% in pregnant women. Although 19.5% of Australian pregnant women visit a chiropractor for pelvic girdle pain, little is known about the experience of pregnant women who seek this care. The aim of this study was to describe and explore the experiences of Australian pregnant women who seek chiropractic care for their current pregnancy-related low back and/or pelvic girdle pain.

          Methods

          A qualitative case study approach with purposive sampling from 27 chiropractic practices was used. A grounded theory approach was informed by a constructivist and interpretivist stance, which provided understanding and meaning to the pregnant women’s experiences. Online unstructured interviews were recorded, transcribed, and anonymised. A thematic analysis was subsequently conducted on the primary data. Codes and major themes were developed with the use of critical self- reflection (memos), survey finding triangulation and respondent validation.

          Results

          Sixteen potential respondents expressed interest in participating. After eligibility screening and data saturation, nine interviews were undertaken. Four key themes were identified: “Care drivers: what drives care seeking?”, “Care barriers: what barriers are encountered?”, “Chiropractic treatment: what does treatment consist of?” and “Response to care: what response was there to care?”.

          Conclusion

          Four key themes: care drivers, care barriers, chiropractic treatment, and response to care support an emergent substantive-level theory in women’s care seeking experiences for pregnancy-related back pain and chiropractic care. This theory is that chiropractic care for pregnant women experiencing low back pain and pelvic girdle pain may improve pain and function, while reducing pregnancy-related biopsychosocial concerns. The findings may inform antenatal health providers and the chiropractic profession about pregnant women’s experience seeking chiropractic care as well as directing future research.

          Supplementary Information

          The online version contains supplementary material available at 10.1186/s12998-023-00516-x.

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          Most cited references29

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          Consolidated criteria for reporting qualitative research (COREQ): a 32-item checklist for interviews and focus groups.

          A Tong, P SAINSBURY, J. Craig (2007)
          Qualitative research explores complex phenomena encountered by clinicians, health care providers, policy makers and consumers. Although partial checklists are available, no consolidated reporting framework exists for any type of qualitative design. To develop a checklist for explicit and comprehensive reporting of qualitative studies (in depth interviews and focus groups). We performed a comprehensive search in Cochrane and Campbell Protocols, Medline, CINAHL, systematic reviews of qualitative studies, author or reviewer guidelines of major medical journals and reference lists of relevant publications for existing checklists used to assess qualitative studies. Seventy-six items from 22 checklists were compiled into a comprehensive list. All items were grouped into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. Duplicate items and those that were ambiguous, too broadly defined and impractical to assess were removed. Items most frequently included in the checklists related to sampling method, setting for data collection, method of data collection, respondent validation of findings, method of recording data, description of the derivation of themes and inclusion of supporting quotations. We grouped all items into three domains: (i) research team and reflexivity, (ii) study design and (iii) data analysis and reporting. The criteria included in COREQ, a 32-item checklist, can help researchers to report important aspects of the research team, study methods, context of the study, findings, analysis and interpretations.
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            Grounded theory research: Procedures, canons, and evaluative criteria

            Juliet Corbin, Anselm Strauss (1990)
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              Grounded theory research: A design framework for novice researchers

              Ylona Chun Tie, Melanie Birks, Karen D. Francis (2019)
              Background: Grounded theory is a well-known methodology employed in many research studies. Qualitative and quantitative data generation techniques can be used in a grounded theory study. Grounded theory sets out to discover or construct theory from data, systematically obtained and analysed using comparative analysis. While grounded theory is inherently flexible, it is a complex methodology. Thus, novice researchers strive to understand the discourse and the practical application of grounded theory concepts and processes. Objective: The aim of this article is to provide a contemporary research framework suitable to inform a grounded theory study. Result: This article provides an overview of grounded theory illustrated through a graphic representation of the processes and methods employed in conducting research using this methodology. The framework is presented as a diagrammatic representation of a research design and acts as a visual guide for the novice grounded theory researcher. Discussion: As grounded theory is not a linear process, the framework illustrates the interplay between the essential grounded theory methods and iterative and comparative actions involved. Each of the essential methods and processes that underpin grounded theory are defined in this article. Conclusion: Rather than an engagement in philosophical discussion or a debate of the different genres that can be used in grounded theory, this article illustrates how a framework for a research study design can be used to guide and inform the novice nurse researcher undertaking a study using grounded theory. Research findings and recommendations can contribute to policy or knowledge development, service provision and can reform thinking to initiate change in the substantive area of inquiry.
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                Author and article information

                Contributors
                Maria Bernard-Giglio:
                ORCID: http://orcid.org/0000-0003-3051-7927
                maria.giglio@students.mq.edu.au
                Journal
                Journal ID (nlm-ta): Chiropr Man Therap
                Journal ID (iso-abbrev): Chiropr Man Therap
                Title: Chiropractic & Manual Therapies
                Publisher: BioMed Central (London )
                ISSN (Electronic): 2045-709X
                Publication date (Electronic): 3 October 2023
                Publication date PMC-release: 3 October 2023
                Publication date Collection: 2023
                Volume: 31
                Electronic Location Identifier: 43
                Affiliations
                [1 ]Department of Chiropractic, Faculty of Medicine, Health and Human Sciences, Macquarie University, ( https://ror.org/01sf06y89) Sydney, Australia
                [2 ]Department of Sports Science and Clinical Biomechanics, University of Southern Denmark, ( https://ror.org/03yrrjy16) Campusvej 55, Odense M, 5230 Denmark
                [3 ]Chiropractic Knowledge Hub, University of Southern Denmark, ( https://ror.org/03yrrjy16) Campusvej 55, Odense M, 5230 Denmark
                [4 ]GRID grid.1023.0, ISNI 0000 0001 2193 0854, Discipline of Chiropractic, School of Health, Medical and Applied Sciences, , CQ University, ; Brisbane, Australia
                Author information
                http://orcid.org/0000-0003-3051-7927
                Article
                Publisher ID: 516
                DOI: 10.1186/s12998-023-00516-x
                PMC ID: 10546639
                PubMed ID: 37789336
                SO-VID: df94e36b-311f-49ac-aacb-b1976a8636b3
                Copyright © © Chiropractic and Osteopathic College of Australasia, European Academy of Chiropractic, The Royal College of Chiropractors, Nordic Institute of Chiropractic and Clinical Biomechanics and BioMed Central Ltd. 2023
                License:

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/. The Creative Commons Public Domain Dedication waiver ( http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated in a credit line to the data.

                History
                Date received : 3 September 2022
                Date accepted : 13 September 2023
                Categories
                Subject: Research
                Custom metadata
                issue-copyright-statement © Chiropractic and Osteopathic College of Australasia, European Academy of Chiropractic, The Royal College of Chiropractors, Nordic Institute of Chiropractic and Clinical Biomechanics and BioMed Central Ltd. 2023

                ScienceOpen disciplines: Complementary & Alternative medicine
                Keywords: chiropractic,pregnancy,low back pain,pelvic girdle pain,qualitative case study,spinal manipulation
                Data availability:
                ScienceOpen disciplines: Complementary & Alternative medicine
                Keywords: chiropractic, pregnancy, low back pain, pelvic girdle pain, qualitative case study, spinal manipulation

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