Background
Psychosocial factors strongly influence musculoskeletal (MSK) outcomes, yet their systematic assessment remains inconsistent in physiotherapy practice. Although validated psychosocial assessment tools exist, little is known about how UK MSK physiotherapists use them.
Objective
To explore UK physiotherapists’ perceptions, practices, and confidence regarding psychosocial assessment, and to identify key challenges and facilitators.
Design
Cross-sectional online survey.
Methods
An anonymous online questionnaire was distributed via professional networks and social media to qualified UK-based MSK physiotherapists. Questions focused on demographics, perceptions, practices, and challenges/facilitators regarding psychosocial assessment. Quantitative data were analysed descriptively and using non-parametric statistics; free-text responses were examined narratively.
Results
373 physiotherapists responded, from a range of roles and experience levels. Most rated psychosocial factors as highly important and reported they often influenced treatment planning. Assessment relied mainly on clinical judgement and explicit questioning, while formal tool use was uncommon. Confidence in identifying and interpreting psychosocial factors showed moderate positive associations with screening tool use and weak or no associations with years of clinical experience. The most cited challenges to use of validated tools were time constraints, and training, whereas concise tools, electronic integration, and evidence of patient benefit were viewed as key facilitators.
Conclusions
UK MSK physiotherapists recognise the importance of psychosocial assessment, but its application in routine practice remains inconsistent and largely informal. Confidence appears to be more closely related to exposure to psychosocial screening tools than to years of clinical experience. These findings highlight the need for approaches that support consistent psychosocial assessment within routine MSK care.
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