title: How Competent Are Healthcare Professionals in Working According to a Bio-Psycho-Social Model in Healthcare? The Current Status and Validation of a Scale.
abstract: 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.
  
  
  METHODS
  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 α 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 α ranged from 0.75 to 0.82). ICC ranged between 0.82 and 0.93.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Occupational Therapy, Artevelde University College, Ghent, Belgium.|Faculty of Medicine and Health Sciences, Department of Rehabilitation Sciences and Physiotherapy, Occupational Therapy Programme, Ghent University, Ghent, Belgium.
authors.forename: Dominique
authors.identifier: http://orcid.org/0000-0001-6982-1075
authors.initials: D
authors.lastname: Van de Velde
authors.affiliation: Department of Occupational Therapy, Artevelde University College, Ghent, Belgium.
authors.forename: Ank
authors.initials: A
authors.lastname: Eijkelkamp
authors.affiliation: Faculty of Medicine and Health Care Sciences, Department of Family Medicine and Primary Health Care, Ghent University, Ghent, Belgium.
authors.forename: Wim
authors.initials: W
authors.lastname: Peersman
authors.affiliation: Department of Occupational Therapy, Artevelde University College, Ghent, Belgium.|Department Gerontology and Frailty in Ageing (FRIA) Research Group, Vrije Universiteit Brussel, Brussels, Belgium.
authors.forename: Patricia
authors.initials: P
authors.lastname: De Vriendt
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D003695:Delivery of Health Care; D005163:Factor Analysis, Statistical; D005260:Female; D017144:Focus Groups; D006282:Health Personnel / Q000523:psychology*; D006801:Humans; D008297:Male; D008875:Middle Aged; D008962:Models, Theoretical; D011594:Psychometrics; D060756:Social Networking; D011795:Surveys and Questionnaires