Physiotherapists' assessment of patients' psychosocial status: are we standing on thin ice? A qualitative descriptive study.

Pain is a complex problem and one that confronts many physiotherapists' working in private practice on a daily basis. While physiotherapists' understanding of pain has matured a great deal in recent times, especially the role of psychosocial (PS) factors, it is unclear if and how, physiotherapists assess their patients' psychosocial status in clinical practice. The aim of this study was to explore private practice physiotherapists' assessment of patients' psychosocial status. A qualitative descriptive research design was used in this study. Participants were recruited through purposeful sampling and potential informants were invited to participate through letters or phone calls and data was collected via semi-structured interviews. Nine semi-structured interviews were conducted at the participants' workplaces. Data collection and analysis were conducted simultaneously and common concepts and themes were recognised, coded and grouped together into themes. Analysis of the data resulted in identification of various themes related to physiotherapists' assessment of patients' PS status. These themes relate to; physiotherapists capacity to conduct PS assessment, the barriers they face while conducting PS assessment and the suggestions they have provided to overcome these barriers. In general the physiotherapists' in this study demonstrated and acknowledged a poor understanding of the role of PS factors in their patients' clinical presentation. They were also unclear about the assessment of psychosocial factors. The barriers to assessment of psychosocial factors ranged from individual shortcomings to limitations in professional networks and time constraints. The most consistent barrier highlighted was participants' lack of formal education in PS theory and assessment.