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. 2025 Mar 27;25(1):451.
doi: 10.1186/s12913-025-12540-z.

A national survey of osteopaths' conceptions of practice in France: structural validity of the Osteo-TAQfr and the tendency toward technical rationality

Oliver P Thomson  1   2 , Loïc Treffel  3   4 , Agathe Wagner  5 , Erwann Jacquot  6   7 , Jerry Draper-Rodi  8   3   9 , Chantal Morin  3   10 , Brett Vaughan  3   11   12   13
Affiliations

A national survey of osteopaths' conceptions of practice in France: structural validity of the Osteo-TAQfr and the tendency toward technical rationality

Oliver P Thomson et al. BMC Health Serv Res. .

Abstract

Background: Despite the growing popularity of osteopathy in France, little is known about how French osteopaths conceptualise key aspects of their practice, including skills, knowledge, and decision-making. This study aimed to adapt and validate the Osteopaths' Therapeutic Approaches Questionnaire (Osteo-TAQ) for use in a French osteopathic population (Osteo-TAQfr) and to examine the professional profile and core elements of clinical practice among French osteopaths. The first objective was to establish the psychometric properties of the Osteo-TAQfr within a French osteopathic population. The second aim was to explore French osteopaths' conceptions of practice and their approach to patient care, thereby contributing to a broader understanding of the profession in France and its relevance within the discourse on allied health professions (AHPs).

Methods: A cross-sectional study was conducted to (1) adapt and validate the French version of the Osteopaths' Therapeutic Approaches Questionnaire (Osteo-TAQfr) and (2) explore osteopaths' conceptions of practice in France. The translation and cultural adaptation process was informed by cognitive interviews to ensure linguistic and contextual appropriateness. Exploratory Factor Analysis (EFA) was performed to assess the factor structure in the French osteopathic context and Confirmatory Factor Analysis (CFA) was used to test the validity of previously established constructs-Professional Artistry (PA) and Technical Rationality (TR). Internal consistency was evaluated using McDonald's omega (ω).

Results: The survey yielded 1,703 complete responses. Analysis supported a two-factor model with PA andTR subscales, both showing strong reliability estimations (PA ω = 0.882; TR ω = 0.873). Minor theory-informed adjustments improved model fit. A moderate negative correlation was observed between the PA and TR subscales (r=-0.407). Respondents with additional health professions qualifications scored lower on the PA subscale and higher on the TR subscale.

Conclusions: The Osteo-TAQfr is an original tool that assesses conceptions of osteopathic practice in France. Findings reveal a predominance of TR among French osteopaths, characterised by biomedical, technique-driven approaches. These results have significant implications for aligning osteopathic education and practice with contemporary AHP paradigms, including patient-centred care and interdisciplinary collaboration. Further research should explore the transferability of the Osteo-TAQ across other healthcare systems and its potential impact on clinical outcomes and professional development.

Keywords: Allied health profession; Factor analysis; Health workforce; Osteopathic medicine; Osteopathy; Professional practice; Statistical; Validation study.

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Conflict of interest statement

Declarations. Ethics approval and consent to participate: All participants provided informed consent prior to taking part in the study. This study was approved by the Institut de Recherche Franc'Ostéo ethics committee (no. 2024-CEO IRFO-01), and respected the anonymity and privacy of data in accordance with the European directive 2002/58/CE and the General Data Protection Regulation - 2016/679. The research was performed in accordance with the Declaration of Helsinki. Consent for publication: Not applicable. Competing interests: OT is an Associate Editor for BMC Health Service Research and International Journal of Osteopathic Medicine. Receives fees for providing osteopathic clinical services; grants, non-financial support and travel reimbursement from University of Technology Sydney's Faculty of Health - Australian Research Centre in Complementary and Integrative Medicine; speaking/lecture fees from Kookie Learning and Metropolia University of Applied Sciences. JDR reports financial support from Osteopathic Foundation; employment with National Council for Osteopathic Research; fees for providing osteopathic clinical services; grants, non-financial support and travel reimbursement from Osteopathy Europe; non-financial support and travel reimbursement from University of Technology Sydney's Faculty of Health - Australian Research Centre in Complementary and Integrative Medicine; speaking/lecture fees from Kookie Learning and Metropolia University of Applied Sciences; and consulting/advisory fees from College of Health Sciences Fribourg. LT reports employment in Institut Toulousain d’Ostéopathie; financial support for Continuing Professional Development in Osteopathy, fees for providing osteopathic clinical services; non-financial support and travel reimbursement from University of Technology Sydney's Faculty of Health - Australian Research Centre in Complementary and Integrative Medicine. EJ reports employment in Centre International d’Ostéopathie; fees for providing osteopathic clinical services; financial support for Continuing Professional Development in osteopathy and pedagogy; lecture fees from SERFA Continuing Professional Development Université Haute-Alsace; non-financial support from University of Paris Cité– Institut des Sciences du Sport-Santé de Paris. AW reports employment in Centre Européen d’Enseignement Supérieur d’Ostéopathie CEESO Paris; Fees for providing osteopathic clinical services; Financial support for Continuing Professional Development in Osteopathy; Lectures fees from Kookie Learning and advisory fees from College of Health Sciences Fribourg. CM reports employment in Université de Sherbrooke; non-financial support and travel reimbursement from University of Technology Sydney's Faculty of Health - Australian Research Centre in Complementary and Integrative Medicine; speaking/lecture fees from Kookie Learning. BV reports employment at the University of Melbourne; non-financial support and travel reimbursement from University of Technology Sydney's Faculty of Health - Australian Research Centre in Complementary and Integrative Medicine; fees for providing osteopathic clinical services.

Figures

Fig. 1
Fig. 1
Diagram illustrating the conception of practice continuum and associated dimensions [90, 94]
Fig. 2
Fig. 2
Translation and adaptation steps of the Osteo-TAQ to the French version (Osteo-TAQfr)
Fig. 3
Fig. 3
Analysis of the Osteo-TAQfr
Fig. 4
Fig. 4
Likert plot of responses to the Osteopaths’ Therapeutic Approaches Questionnaire (Osteo-TAQfr) items
See this image and copyright information in PMC

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