Culturally sensitive self-management practice: a mature biopsychosocial model to improve outcomes for people living with chronic musculoskeletal conditions

Abstract

Introduction: Musculoskeletal conditions account for a substantial proportion of disability worldwide and place a sustained burden on individuals, healthcare systems and society. As demand for musculoskeletal care increasingly exceeds service capacity, there is a growing need for approaches that enhance access to care, support effective self-management and improve outcomes for diverse patient populations. To ensure the optimisation of self-management delivery and health equality for all healthcare seekers and communities, we argue that it will be necessary to adapt and evolve physiotherapy practice through the appreciation of the overarching influence of culture.

Purpose: In this paper, we examine the biopsychosocial model and consider the influence of culture with regard to self-management.

Implications: To support optimal implementation of a culturally sensitive framework, we argue the need for a mature bio-psychosocial model to underpin self-management practice, where the overarching influence of culture is clear and the risks of culturally insensitive care appreciated. The potential impact of adopting this mature bio-psychosocial model is discussed in relation to musculoskeletal physiotherapy practice, using digital self-management support (virtual interfaces, applications (apps) and devices) as an exemplar. In support of the optimisation of self-management outcomes for diverse communities with chronic musculoskeletal conditions, a mature bio-psychosocial model is proposed. Future training and research are recommended to increase cultural competence.

Keywords: Culture; Musculoskeletal; Physiotherapy; Self-management.