How competent are healthcare professionals in working according to a bio-psycho-social model in healthcare? : the current status and validation of a scale

Background : Over the past decades, there has been a paradigm shift from a purely biomedical towards a bio-psycho-social (BPS) conception of disability and illness, which has led to a change in contemporary healthcare. However, there seems to be a gap between the rhetoric and reality of working within a BPS model. It is not clear whether healthcare professionals show the necessary skills and competencies to act according to the BPS model. Objective : The aim of this study was (1) to develop a scale to monitor the BPS competencies of healthcare professionals, (2) to define its factor-structure, (3) to check internal consistency, (4) test-retest reliability and (5) feasibility. Design and Setting : Item derivation for the BPS scale was based on qualitative research with seven multidisciplinary focus groups (n = 58) of both patients and professionals. In a cross-sectional study design, 368 healthcare professionals completed the BPS scale through a digital platform. An exploratory factor analysis was performed to determine underlying dimensions. Statistical coherence was expressed in item-total correlations and in Cronbach's alpha coefficient. An intra-class-correlation coefficient was used to rate the test-retest reliability. Results : The qualitative study revealed 45 items. The exploratory factor analysis showed five underlying dimensions labelled as: (1) networking, (2) using the expertise of the client, (3) assessment and reporting, (4) professional knowledge and skills and (5) using the environment. The results show a good to strong homogeneity (item-total ranged from 0.59 to 0.79) and a strong internal consistency (Cronbach's alpha ranged from 0.75 to 0.82). ICC ranged between 0.82 and 0.93. Conclusion : The BPS scale appeared to be a valid and reliable measure to rate the BPS competencies of the healthcare professionals and offers opportunities for an improvement in the healthcare delivery. Further research is necessary to test the construct validity and to detect whether the scale is responsive and able to detect changes over time

Graphical representation of the results of the BPS scale in a polar pie divided per subscale (n = 368), min. score: 1, max. score: 5.

<p>Graphical representation of the results of the BPS scale in a polar pie divided per subscale (n = 368), min. score: 1, max. score: 5.</p

Internal consistency: Cronbach’s α for each subscale before and after item-reduction (n = 368), test-retest reliability comparing T1 with T2: ICC on scale level (n = 35).

<p>Internal consistency: Cronbach’s α for each subscale before and after item-reduction (n = 368), test-retest reliability comparing T1 with T2: ICC on scale level (n = 35).</p

Flow chart of the development process of the BPS scale.

<p>Flow chart of the development process of the BPS scale.</p

Exploratory factor analysis: rotated loading matrix^* (n = 368).

<p>Exploratory factor analysis: rotated loading matrix^{<a href="http://www.plosone.org/article/info:doi/10.1371/journal.pone.0164018#t002fn002" target="_blank">*</a>} (n = 368).</p

Histograms of the different subscales, displaying the normal curve (n = 368).

<p>Histograms of the different subscales, displaying the normal curve (n = 368).</p

Characteristics of the participants (n = 368).

<p>Characteristics of the participants (n = 368).</p