Assessing psychosocial profile in the physical therapy setting

Abstract

Purpose Physical therapists play a crucial role in managing persistent pain and disability. Since psychosocial factors are important predictors of poor patient outcomes, it is essential that clinicians understand how to utilize validated instruments to assess psychosocial profile in the clinical setting. The following article reviews the psychometric properties and clinical application of the Keele Subgroups for Targeted Treatment Back Screening Tool (SBT), Optimal Screening for Prediction of Referral and Outcome Yellow Flag (OSPRO‐YF), Pain Catastrophizing Scale (PCS), Tampa Scale of Kinesiophobia (TSK), Pain Self‐Efficacy Questionnaire (PSEQ), and Patient Health Questionnaire (PHQ). Results Multidimensional screening tools, such as the SBT and OSPRO‐YF, are useful prognostic indicators of long‐term disability and the presence of yellow flags that may be contributing to patient presentation, respectively. This can guide both the treatment and administration of specific, unidimensional psychosocial assessment tools. The following cutoffs are identified as moderate elevation of psychosocial profile which can be used to inform clinical practice: PCS ≥20, TSK >37, PSEQ ≥40, and PHQ‐9 ≥10. Conclusion Valid and reliable unidimensional and multidimensional psychosocial assessment tools provide important prognostic information to inform a patient's psychosocial profile and subsequently improve clinical efficiency and patient outcomes.

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“…Total scores range from 0 to 52 and higher scores indicate greater pain catastrophizing. 18,22 Tampa Scale for Kinesiophobia…”

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“…She reported a score of two on the pain NRS for her left patella area; the result of a ballottement test was negative, her stroke test score was 1+, and there was a reduction in inflammatory symptoms. However, the patient's score on the Pain Catastrophizing Scale (PCS) was high at 25 points, indicating pain catastrophizing (Wyngaarden et al., 2019). The Japanese version of the PCS (J‐PCS), which has been confirmed to be highly reliable and valid, was used (Iwaki et al., 2012; Matsuoka & Sakano, 2007).…”

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“…Scores on the PCS range between 0 and 52, where higher scores represent higher levels of pain catastrophizing. PCS scores of 20 or higher have been suggested as a cutoff for moderate levels of pain catastrophizing [38]. The PCS has shown good reliability, internal consistency, construct validity, and concurrent validity [28,39].…”

“…Scores on the TSK range between 13 and 52, where higher scores represented a greater fear of movement. TSK scores of 37 or higher have been suggested as a cutoff for moderate levels of fear of movement [38]. The TSK has been found to have good internal consistency and test-retest reliability [29,41].…”