Physiotherapists Using the Biopsychosocial Model for Chronic Pain: Barriers and Facilitators—A Scoping Review

Han van Dijk (), Albère J. A. Köke, Stefan Elbers, Jurgen Mollema, Rob J. E. M. Smeets and Harriët Wittink
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Han van Dijk: Research Group Lifestyle and Health, Utrecht University of Applied Sciences, 3584 CH Utrecht, The Netherlands
Albère J. A. Köke: Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, 6211 LK Maastricht, The Netherlands
Stefan Elbers: Kantar Public, Behavioural Insights & Communications, 1079 LH Amsterdam, The Netherlands
Jurgen Mollema: Research Group Lifestyle and Health, Utrecht University of Applied Sciences, 3584 CH Utrecht, The Netherlands
Rob J. E. M. Smeets: Department of Rehabilitation Medicine, Research School CAPHRI, Maastricht University, 6211 LK Maastricht, The Netherlands
Harriët Wittink: Research Group Lifestyle and Health, Utrecht University of Applied Sciences, 3584 CH Utrecht, The Netherlands

IJERPH, 2023, vol. 20, issue 2, 1-15

Abstract: The use of the biopsychosocial model in primary care physiotherapy for chronic pain is far from the recommendations given in research and current guidelines. To understand why physiotherapists have difficulty implementing a biopsychosocial approach, more insight is needed on the barriers and facilitators. This scoping review aimed to investigate and map these barriers and facilitators that physiotherapists working in primary care reportedly face when treating patients with chronic musculoskeletal pain from a biopsychosocial perspective. Four electronic databases (PubMed, Embase, CINAHL and ERIC) and the grey literature were searched. Studies were included if they investigated the experiences of physiotherapists in the treatment of chronic pain from a biopsychosocial perspective in primary care. Extracted data were discussed and sub grouped in themes following a qualitative content analysis approach. To align with current use of theories on behavior change, the resulting themes were compared to the Theoretical Domains Framework. After screening, twenty-four studies were included. Eight groups of barriers and facilitators were identified, thematically clustered in six themes: knowledge, skills, and attitudes; environmental context and resources; role clarity; confidence; therapeutic alliance; and patient expectations. The results of this review can be used to inform the development of implementation programs.

Keywords: chronic pain; biopsychosocial; physiotherapy; primary health care; barriers and facilitators (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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