暸解台灣醫師對於脊骨神經醫學的認知之初探

Abstract

脊骨神經醫學在北美洲、歐洲及澳洲已有上百年的歷史，在治療神經、肌肉、骨骼的相關問題是被民眾普遍的使用，且具有高度的療效和滿意度。反觀亞洲國家，除了文化上的差異之外，民眾和醫界對於脊骨神經醫學的瞭解還依舊存有高度的質疑。本論文以質性研究的架構，以深度訪談的方式訪問十二位在台灣的執業醫師，瞭解他們對於脊骨神經的認知以及看法。分析方法主要採用口語資料分析法，先將訪談內容整理成逐字稿，在根據主題與內容的關聯性進行概念化定義及編碼 (coding)，當資料被分解成一個個單位後，在進而分析資料裡所反映的現象。在分析後發現，醫師們對於脊骨神經醫學瞭解上的不足，造成了許多對於此專業的誤解。在制定相關法案的看法上，多半醫師雖然普遍不樂觀，但是都贊成政府以立法的方式，讓一般民眾在尋求相關解決辦法時，能夠更有保障。

Background: Chiropractic is a health care profession in the Western society for over a century. It is the largest profession in the Complementary and Alternative Medicine system, and is considered as the closest to the mainstream. After massive amount of research, it is evident that chiropractic not only gains high patient satisfactory rate, it is also a very cost-effective approach on treating neuromusculoskeletal conditions. However, it is not widely introduced in the Asian countries, especially in Taiwan. Public, as well as health care workers may not have a clear understanding of what chiropractic profession is all about. Objective: The objective of this study is to understand medical doctors’ perception on chiropractic and to determine the necessity of establishment of such a profession in Taiwan. Method: In-depth, semi-structured interviews were conducted in Mandarin language to twelve licensed medical doctors in Taiwan. Results in the form of narratives were analyzed using common coding technique. Result: Among the twelve medical doctors, most associate chiropractic with rehabilitation or folk therapy. All of them have heard of the term chiropractic, but most have limited knowledge about the scope of practice, length and content of education of the profession. Most participants do not know that chiropractors earn a doctoral credential, and thus relate chiropractors to therapists or technicians. Almost all participants support the legislation to regulate those who perform spinal manipulations, but qualification is a debate. About half of the respondents emphasize on the importance of evidence-based practice. Conclusion: After these in-depth interviews and the narrative analysis, it is evident that numerous misunderstanding about the profession due to lack of knowledge have impeded the development of chiropractic profession in Taiwan. Further research including long-term randomized controlled trials on the efficacy and public demand of chiropractic in Taiwan are recommended.