Physiotherapists’ assessment of patients’ psychosocial status: Are we standing on thin ice? A qualitative descriptive study

In recent years, there has been an increased understanding of the importance of psychosocial factors in the development and maintenance of pain and disability related to musculoskeletal problems. Physiotherapists have traditionally been trained to identify, assess and treat physical factors related to musculoskeletal problems but similar training for psychosocial factors is limited. This study aimed to explore physiotherapists’ thoughts regarding assessment of psychosocial factors.

Physiotherapists appeared to be unsure what factors were included under the term ‘psychosocial factors’ or that psychosocial factors were factors that delayed recovery from pain. They indicated that it was mainly patients with chronic pain or undergoing an a work compensation or insurance claim who had psychosocial factors. Physiotherapists also appeared to be confused about how psychosocial factors might be relevant for their patients condition or what to do when these factors were identified as important for a patient. They reported that assessing psychosocial factors was mainly based on ‘gut feeling’ and that they rarely assessed these factors in a formal manner.

Physiotherapists identified the largest barrier to identifying and assessment of psychosocial factors was the lack of education regarding these factors in undergraduate and postgraduate courses as well as in ongoing CPD courses. The lack of formal training lead them to believe that they were not equipped to deal with these issues and did not possess adequate background knowledge. They identified further training in communication and interaction skills would be helpful and that finding a quick and simple assessment tool would help them identify psychosocial factors.

The study discussed the need for a standardised definition of what is included in the term ‘psychosocial factors’ to help clarify for physiotherapists what is meant by the term. It also identifies that including formal training in undergraduate or postgraduate courses may help physiotherapists feel more comfortable understanding and assessing psychosocial factors and that training should be made available to qualified physiotherapists to enhance their skills.