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

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.