An exploration into the utilisation of the biopsychosocial model by chiropractors in the eThekwini Municipality

Abstract

Background: The biopsychosocial (BPS) model is one of the many models of healthcare and its utilisation has been encouraged when treating and managing musculoskeletal conditions, especially neck and low back pain. Chiropractors are viewed as primary care providers, focused on the treatment and management of musculoskeletal conditions, most of which are spine related. This study aims to explore the utilisation of the biopsychosocial model by chiropractors in the eThekwini Municipality. Method: A qualitative, exploratory, descriptive study was conducted, in which twelve chiropractors within the eThekwini Municipality were interviewed to explore their understanding, attitudes, utilisation and challenges when utilising the BPS model. Semi-structured interviews were conducted in English, and later transcribed verbatim. Transcripts were analysed using Tesch’s method to form codes, themes and subthemes. Results: Female and male chiropractors were interviewed. They displayed knowledge of and a positive attitude towards the BPS model and its constituents. The chiropractors’ felt that chiropractic institutions should implement further practical training in the model to adequately prepare students for practice as many of the interviewees felt that addressing psychosocial factors was beyond their scope of practice and that they did not have the required skills. The most mentioned challenge was time, and how it resulted in constraints when utilising the model. This impacted them being able to implement the model effectively. Few used screening tools citing a lack of training or that they added to the time constraints. Conclusion: Chiropractors had positive attitudes towards and knew about the BPS model. They used the model in their practices to varying degrees with time and skills being the biggest challenges to effective implementation. It is recommended that chiropractic associations and training institutions provide additional practical training to teach students and practitioners how to implement the model in a clinical setting.