Understanding and use of contextual factors in osteopathy: a cross-sectional online survey
Abstract
Introduction: Contextual factors (CFs) refer to elements of the therapeutic context that may influence clinical outcomes, including patient expectations, the therapeutic relationship, touch and the care environment. Although increasingly documented in several healthcare professions, CFs remain underexplored in osteopathy, particularly in the Quebec context. Objective(s): This study aimed to explore how osteopaths in Quebec perceive, define and use CFs in their clinical practice. Methods: A cross-sectional observational online survey was conducted among osteopaths and osteopathy students involved in clinical practice in Quebec. The questionnaire was adapted from a previous survey conducted among French-speaking healthcare professionals and included both closed-ended and open-ended questions. Quantitative data were analyzed descriptively. Open-ended responses were explored through lexicometric analysis of word occurrences and co-occurrences using IRaMuTeQ software. Results: A total of 98 responses were analyzed. Among respondents, 75.5% reported never having received training on CFs, while 81.6% stated that they already used them in practice. The findings suggest a partial and heterogeneous understanding of the concept, with overlap between CFs, the biopsychosocial model, the therapeutic alliance and patient-centered care. Reported use of CFs appeared selective: communication, patients’ past experiences and the care environment were frequently mobilized, whereas physical contact was less often explicitly recognized as a CF. Discussion/Conclusion: CFs appear to be already present in Quebec osteopathic practice, but they remain unevenly recognized, conceptualized and mobilized. Training on their mechanisms, clinical uses and ethical implications could support a more explicit, rigorous and transparent integration into osteopathic education and practice.
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BibTeX
@misc{cayer2026understanding,
title = {{Understanding and use of contextual factors in osteopathy: a cross-sectional online survey}},
author = {Cynthia Cayer and Benoît Hogedez},
howpublished = {HAL},
year = {2026},
month = jul,
url = {https://hal.science/hal-05722567v1},
note = {CC BY-NC-ND 4.0},
}
RIS
TY - UNPB
TI - Understanding and use of contextual factors in osteopathy: a cross-sectional online survey
AU - Cynthia Cayer
AU - Benoît Hogedez
PY - 2026
DA - 2026/07/17
PB - HAL
UR - https://hal.science/hal-05722567v1
AB - Introduction: Contextual factors (CFs) refer to elements of the therapeutic context that may influence clinical outcomes, including patient expectations, the therapeutic relationship, touch and the care environment. Although increasingly documented in several healthcare professions, CFs remain underexplored in osteopathy, particularly in the Quebec context. Objective(s): This study aimed to explore how osteopaths in Quebec perceive, define and use CFs in their clinical practice. Methods: A cross-sectional observational online survey was conducted among osteopaths and osteopathy students involved in clinical practice in Quebec. The questionnaire was adapted from a previous survey conducted among French-speaking healthcare professionals and included both closed-ended and open-ended questions. Quantitative data were analyzed descriptively. Open-ended responses were explored through lexicometric analysis of word occurrences and co-occurrences using IRaMuTeQ software. Results: A total of 98 responses were analyzed. Among respondents, 75.5% reported never having received training on CFs, while 81.6% stated that they already used them in practice. The findings suggest a partial and heterogeneous understanding of the concept, with overlap between CFs, the biopsychosocial model, the therapeutic alliance and patient-centered care. Reported use of CFs appeared selective: communication, patients’ past experiences and the care environment were frequently mobilized, whereas physical contact was less often explicitly recognized as a CF. Discussion/Conclusion: CFs appear to be already present in Quebec osteopathic practice, but they remain unevenly recognized, conceptualized and mobilized. Training on their mechanisms, clinical uses and ethical implications could support a more explicit, rigorous and transparent integration into osteopathic education and practice.
ER -