“Disproportionate Olympic Rings” – The usage of a biopsychosocial (BPS) framework of care when managing people with musculoskeletal pain by osteopaths in Aotearoa/New Zealand– A qualitative study

Abstract

Objectives: To address chronic musculoskeletal (MSK) pain effectively, a multidimensional model of care such as the biopsychosocial (BPS) model may be required. However, to date, the incorporation of the BPS model into osteopathic practice by New Zealand (NZ) osteopaths is unknown. Hence, the aims of this study were to: 1) investigate the incorporation of the BPS model into osteopathic practice by NZ osteopaths; (2) explore the attitudes and perceptions about the BPS model among NZ osteopaths; and (3) investigate the barriers to implementing the BPS model in NZ osteopathic practice. Design: In-depth interviews; data analysed using thematic analysis. Setting: Online. Participants: A total of 14 NZ registered osteopaths (mean age = 49; 57 % males). Results: Thematic analysis revealed three major categories: BPS resistant, BPS open and BPS embracing. A ‘cactus fractal model’ was proposed in which knowledge about the BPS model informs the professional identity of osteopaths and therefore their interaction with the health system. This can take the form of a positive or a negative fractal model. Hence, education about the BPS model during undergraduate training or as CPD courses may be imperative. Conclusions: Participants in this study held a range of views about the usage of the BPS model in their clinical practice. Although, there is still resistance in using the BPS model, emerging evidence indicate that NZ osteopaths are open and/or to embrace the BPS model.