Healthcare providers knowledge and use of psychological and psychoSOCIAL screening and interventions in the management of patients with tendinopathy: An International Survey of Practice

Background Psychological and psychosocial factors play an important role in the management of patients with musculoskeletal disorders. Currently, there is no information exploring how clinicians current practice is informed by these factors in the people with tendinopathy exists. Objectives To explore healthcare providers knowledge and use of psychological and social screening and interventions in the management of patients with tendinopathy Methods An online survey was developed by a group of tendon experts. The survey was disseminated via special interest groups, social networks and professional organisations internationally. Results The survey had 103 completed responses. The majority of respondents used the subjective, 53% (N=55), subjective and objective, 28%(n=29), or objective 6% (n=6) examination to screen for psychological factors using both verbal and nonverbal methods. Psychosocial factors were screened for during the subjective assessment by 75% (n=77) of respondents. A further 15% (n=15) screened during the subjective and objective combined whilst 5% (n=5) examined this factor in the objective assessment in isolation. Psychological screening tools were used by 25% (n= 26) of respondents and psychosocial factors by 12% (n=12) of respondents. Treatment typically comprised of individualised education, reassurance, addressing mal-adaptive behaviours and behaviour change. Confidence in assessment and treatment was mixed and clinicians identified a desire for more specific training and self-development. Conclusion The proportion of clinicians screening and measuring psychological and psychosocial factors in clinical practice is high, but few use validated tools due to a lack of time and confidence. Implication for clinical practice Clinicians commonly assess psychological and social factors during assessment of individuals with tendinopathy, as part of their subjective and objective assessments. It is unclear how successfully clinicians identify these factors during their assessments, as they rarely use validated screening tools. Key message – Clinicians and researchers should examine and modify: fear of movement, Negative pain beliefs, Maladaptive/avoidance behaviors, catastrophisation and Anxiety (psychological constructs) and Quality of life, work related constructs, sleep quality, education health literacy and social interactions(psychoSOCIAL constructs) during clinical or research work. Training needs to be developed to improve clinician confidence when assessing and treating psychological and psychoSOCIAL factors in patients with tendinopathy Further work is needed to examine the barriers and facilitators to the use of appropriate validated psychological and psychoSOCIAL tools in clinical care.