Unwittingly use of the bio-psycho-social model by health care professionals: a grounded theory study

Background: A bio-psycho-social approach has become indispensable in the care for chronically ill and disabled persons. However, effective application of the bio-psycho-social model in current healthcare stagnates for unknown... [ view full abstract ]

Background:
A bio-psycho-social approach has become indispensable in the care for chronically ill and disabled persons. However, effective application of the bio-psycho-social model in current healthcare stagnates for unknown reasons. It was the aim of this study to explore the experiences of clients, healthcare providers, policy makers and trainers in elderly care and physical rehabilitation regarding their professional reasoning based on the bio-psycho-social model.
Method:
A Grounded Theory study with seven focus group interviews with 46 stakeholders. A constant comparative method was used for the analysis.
Results:
Working with the bio-psycho-social model was perceived as: (1) Starting from the client’s perspective, (2) Relying on each other's expertise, (3) A matter of good communication, and (4) Acting pragmatically. In order to understand the medical, personal and social characteristics of a client, professional expertise should go along with a client-centred approach. Professionals experienced a greater trust on their intuition than on theoretically sound methods when it comes to difficult decisions. All participants perceived proper communication and organisational flexibility as indispensable for bio-psycho-social reasoning. Conclusion:
The experiences of different stakeholders shed light on specific features of applying the bio-psycho-social model: (1) mutual trust between client and professional, (2) inter-professional trust, (3) client participation in decision making, (4) univocal communication systems and (5) incompetence of theoretical principles and existing tools.
Application to Practice:
Health care professionals should become aware of the different conditions for better bio-psycho-social reasoning. Knowledge enhancement and skills development are recommended to improve clinical reasoning with the bio-psycho-social model.