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Making sense of complexity: A qualitative ‘Framework’ analysis of naturopathic case management and clinical reasoning
Journal article   Peer reviewed

Making sense of complexity: A qualitative ‘Framework’ analysis of naturopathic case management and clinical reasoning

Kim D. Graham, Amie Steel and Jon Wardle
Complementary therapies in clinical practice, Vol.52, 101773
08/2023
DOI: https://doi.org/10.1016/j.ctcp.2023.101773
PMID: 37247568

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Abstract

Clinical reasoning Complexity Naturopathy Primary health care
Background and purpose The clinical encounter is inherently complex and uncertain. Naturopathic clinical practice is shaped by a traditional philosophy and practice guiding principles, with a therapeutic framework that incorporates a complex inter-systems approach. It is possible that this foundation may orient naturopathic practitioners to manage clinical complexity and uncertainty in a distinct manner. The aim of this study is to explore the perceptions of experienced naturopathic practitioners to the management of clinical complexity within naturopathic care. Materials and methods Twenty experienced Australian naturopathic practitioners participated across four focus groups, responding to semi-structured questions regarding their clinical reasoning strategies and case management processes. The data were analysed using a seven step Framework analysis method. Results Three primary themes were identified: i) patient is encountered as a whole entity, ii) clinical reasoning is ampliative and explicative, and iii) treatment reflects systems thinking. Participants perceived a focus on the connections between various case elements, building a comprehensive internalised schematic of each case. Participants saw treatments as meeting various needs including prevention, symptom alleviation, causal mitigation, and support of innate healing processes. Conclusion Naturopathic practitioners perceive they clinically embody the traditional holistic philosophy of naturopathy as a systems orientation, incorporating traditional and contemporary bioscience knowledge. This appears to shape a distinct naturopathic case management approach, oriented to working with patients in a complexity-informed manner.

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