# Patient Perceptions of Traditional Bonesetters and Determinants of Their Utilization: A Cross‐Sectional Study in Iraqi Kurdistan

## TL;DR

This study explores why people in Iraqi Kurdistan prefer traditional bonesetters over modern orthopedic care, finding that negative hospital experiences and fear of procedures are key factors.

## Contribution

The study identifies specific determinants influencing preference for traditional bonesetters in a Kurdish population.

## Key findings

- 34.9% of participants had positive perceptions of traditional bonesetters.
- Disagreement with hospital staff attitudes and fear of hospital procedures significantly predicted preference for traditional bonesetters.
- Financial constraints and cultural factors were not significant predictors of TBS utilization.

## Abstract

Despite the prevalent reliance on traditional bonesetters (TBSs) in Kurdish societies, their role remains underexplored in scholarly research. This study aimed to evaluate patients' perceptions of TBSs and to investigate the determinants of their utilization over modern orthopedic care.

A cross‐sectional study was conducted from August 20 to September 20, 2022, using purposive sampling. A structured questionnaire, adapted from prior studies and validated (Cronbach's α = 0.73), assessed sociodemographic characteristics, healthcare experiences, and perceptions. χ
2 test and multivariate logistic regression analysis were applied to identify factors associated with perspectives toward TBSs.

The study included 106 participants. The majority of participants were aged 18–45 (62%), 51.9% male, and 61.3% urban residents. Perceptions toward TBSs were 34.9% positive, 34.9% negative, and 30.2% neutral. The mean perception score was 4.80 ± 1.40, with 5 as the cutoff for neutral perception. Multivariate analysis revealed that disagreement with hospital staff attitudes (AOR = 0.04, 95% CI: 0.07–0.23, p < 0.001) and fear of hospital procedures (AOR = 0.13, 95% CI: 0.02–0.85, p = 0.033) were significant predictors of TBS preference, while financial constraints and cultural factors were not significant.

The continued reliance on TBSs in Northern Iraq highlights a critical gap in patient trust toward formal healthcare systems, particularly regarding hospital staff interactions and procedural concerns. Addressing hospital staff attitudes and improving patient confidence in modern medical procedures may help shift preferences toward evidence‐based orthopedic care.