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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.
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PURPOSE: To study the preliminary effects and feasibility of the “Traffic Light Method for somatic screening and lifestyle” (TLM) in patients with severe mental illness. DESIGN AND METHODS: A pilot study using a quasi-experimental mixed method design with additional content analyses of lifestyle plans and logbooks. FINDINGS: Significant improvements were found in body weight and waist circumference. Positive trends were found in patients’ subjective evaluations of the TLM. The implementation of the TLM was considered feasible. PRACTICE IMPLICATIONS: The TLM may contribute to a higher quality of care regarding somatic screening and lifestyle training.
