title: Immunization and the chiropractor-patient interaction: a Western canadian study.
abstract: OBJECTIVE
  To explore how the topic of vaccination arises during interactions between chiropractors and their patients, the advice that is given to patients, and the factors that influence the opinions of the chiropractors.
  
  
  METHODS
  Data were collected in semistructured interviews with a purposeful sample of chiropractors in Calgary, Canada. Data were analyzed using qualitative content analysis and constant comparison. Participants were chiropractors who had participated in a postal survey of immunization-related beliefs and behaviors and who consented to contact for further study.
  
  
  RESULTS
  Data redundancy was attained after 14 interviews were complete. Immunization arose in clinical encounters by both indirect (provision of reference materials and/or posting of media stories in clinic waiting rooms) and direct communication. Direct communications were most commonly patient initiated and were prompted by media reports, clinic waiting room material, or patient perceived adverse reactions; however, they were also initiated by the chiropractors, particularly if they were seeing young children with their parents. For some chiropractors, the emphasis was on providing information of a negative, antivaccination nature; others referred clients to physicians and nurses. Factors that influenced their opinions included their chiropractic training, philosophy of health and illness, and self or important others having experienced negative reactions that were perceived to result from immunization.
  
  
  CONCLUSIONS
  Both patients and chiropractors initiate discussions on immunization in practice, with many chiropractors using indirect stimuli to open the topic. Doctors of chiropractic in this particular sample were heterogeneous with respect to the information provided to patients. However, study findings may not be generalizable outside Canada.
authors.affiliation: Office of Medical Bioethics, University of Calgary, Calgary, Canada.
authors.forename: Stacey A
authors.initials: SA
authors.lastname: Page
authors.forename: Margaret L
authors.initials: ML
authors.lastname: Russell
authors.forename: Marja J
authors.initials: MJ
authors.lastname: Verhoef
authors.forename: H Stephen
authors.initials: HS
authors.lastname: Injeyan
mesh_terms: D001291:Attitude of Health Personnel; D002170:Canada; D002684:Chiropractic; D003142:Communication; D006801:Humans; D007114:Immunization; D011369:Professional-Patient Relations