Covid-19 Research

Review Article

Psychosocial Dynamics in Acute Injury Rehabilitation: A Scoping Review of Provider–Patient Relationships

Journal of Biomedical Research & Environmental Sciences article abstract with citation details, DOI, publication dates, subject areas, full text links, and references.

View DOI Submit Manuscript

Article Details

Publication record, authors, dates, abstract, and full text access.

Open Access
Article Type Review Article
Subject General Science
OCLC JBRES Record
Ubon Akpan*, David Collins, Alan C MacPherson and Sandi Lyall
Issue: Volume7-Issue6
Pages: 1-22
Received: 2026-03-21
Accepted: 2026-06-08
Published: 2026-06-10

Abstract

Background: As an important contributor to rehabilitation outcomes for individuals experiencing acute injury, the provider-patient relationship has attracted research attention. Conventionally, physiotherapy has prioritised the biomedical approaches in the treatment of patients. However, recent interest in the role of psychosocial factors in therapeutic practice indicates the need for a comprehensive understanding of how relational dynamics impact rehabilitation. Therefore, the purpose of this scoping review was to identify and synthesise pertinent empirical evidence regarding the effects of psychosocial factors on provider-patient interactions during rehabilitation for patients experiencing acute injury.
Methods: A systematic search was conducted using CINAHL, PubMed, Scopus, and SPORTDiscus. Studies investigating psychosocial factors influence on the provider-patient interaction in acute physiotherapy were considered. Specifically, studies between 2015 and 2025 were selected if they examined psychosocial factors, including interpersonal communication, emotional aspects, and therapeutic alliance within the context of rehabilitation. Twenty-nine studies were finally selected for inclusion in the analysis. The studies included patients, athletes, and health care providers.
Results: After careful selection, data from each study were analysed and synthesised into thematic areas. Five main themes emerged: Therapist behaviours and interactions; Patient behaviours and responses; Systemic and Organisational Factors; Therapy Adaptations; and Geographic Disparities in Therapy. Some themes also produced relevant sub-themes. Findings emphasised the need for a therapeutic relationship that encompassed: effective communication, person-centred care, collaborative efforts, and structural supports to enhance rehabilitation outcomes for patients. Implications for the development of relational skills in practitioners that promote patient engagement and improve the quality of recovery are considered and discussed.
Conclusion: Psychosocial factors are critical to successful acute rehabilitation. However, there exists a gap in translating biopsychosocial concepts into practice to meet both the physical and the psychological healthcare needs of patients.

FullText HTML FullText PDF DOI: 10.37871/jbres2305 Crossmark

Certificate of Publication

Certificate of Publication

Copyright

© 2026 Akpan U, et al. Distributed under Creative Commons CC-BY 4.0 Creative CommonsAttribution

How to cite this article

Akpan U, Collins D, MacPherson AC, Lyall S. Psychosocial Dynamics in Acute Injury Rehabilitation: A Scoping Review of Provider–Patient Relationships. J Biomed Res Environ Sci. 2026 June 10; 7(6): 22. Doi: 10.37872/jbres2305

Subject area(s)

Rehabilitation

References

  1. Aagaard PK, Lyngbye Lollesgaard L, Larsen P, Elsøe R, Rathleff MS. Patients' experiences and preferences for rehabilitation following an ankle fracture. Eur J Physiother. 2025;27(3):193-200. doi:10.1080/21679169.2024.2385311.
  2. Asplin G, Carlsson G, Fagevik Olsén M, Zidén L. See me, teach me, guide me, but it's up to me! Patients' experiences of recovery during the acute phase after hip fracture. Eur J Physiother. 2021;23(3):135-143. doi:10.1080/21679169.2019.1650394.
  3. Bachelor A. Clients' and therapists' views of the therapeutic alliance: similarities, differences and relationship to therapy outcome. Clin Psychol Psychother. 2013;20(2):118-135. doi:10.1002/cpp.792.
  4. Bordin ES. The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy (Chic). 1979;16(3):252-260. doi:10.1037/h0085885.
  5. Bretherton C, Al-Saadawi A, Sandhu PH, Baird PJ, Griffin PX. Healthcare professionals beliefs and priorities for the rehabilitation of patients after ankle fracture surgery: a qualitative study. Injury. 2024;55(12):111975. doi:10.1016/j.injury.2024.111975.
  6. Burland JP, Toonstra J, Werner JL, Mattacola CG, Howell DM, Howard JS. Decision to return to sport after anterior cruciate ligament reconstruction, part I: a qualitative investigation of psychosocial factors. J Athl Train. 2018;53(5):452-463. doi:10.4085/1062-6050-313-16.
  7. Byrne M, Campos C, Daly S, Lok B, Miles A. The current state of empathy, compassion and person-centred communication training in healthcare: an umbrella review. Patient Educ Couns. 2024;119:108063. doi:10.1016/j.pec.2023.108063.
  8. Carolan D, O'Neill S, White B, Lyons F, Colgan G, Ramiah V, et al. Patients' experiences of a Virtual Fracture Assessment Clinic Pathway: a qualitative study. PLoS One. 2025;20(4):e0321400. doi:10.1371/journal.pone.0321400.
  9. Caron JG, Cadotte G, Collict C, van Ierssel J, Podlog L. Exploring the factors involved in being "ready" to return to sport following a concussion. Clin J Sport Med. 2023;33(4):395-404. doi:10.1097/JSM.0000000000001101.
  10. Carter H, Beard D, Dodsley C, Leighton P, McCallion J, Moffatt F, et al. Use of a shared decision-making intervention to support treatment decision-making for patients following an anterior cruciate ligament rupture: a mixed methods feasibility study. BMJ Open. 2025;15(8):e095189. doi:10.1136/bmjopen-2024-095189.
  11. Christensen I, Power E, Togher L, Norup A. "It Does Not Always Need To Be Staff Choosing the Agenda": The experiences of people with traumatic brain injury when communicating with rehabilitation staff. Am J Speech Lang Pathol. 2025;34(5):1-17. doi:10.1044/2025_AJSLP-25-00032.
  12. Courraud C, Lieutaud A, Bois D. The sensible and identity crisis of healthcare workers: the perspective of physiotherapists practicing fasciatherapy. Sociology Study. 2018;8(1). doi:10.17265/2159-5526/2018.01.001.
  13. Chua J, Reid D, Keung S, Jewell S, Deadman O, Theadom A. 'Their role has a lot of purpose beyond being just being about exercises': a qualitative study of patients' experiences of physiotherapy following a mild traumatic brain injury. BMJ Open Sport Exerc Med. 2024;10(3):e002027. doi:10.1136/bmjsem-2024-002027.
  14. Devlin AS, Andrade CC. Quality of the Hospital Experience: Impact of the Physical Environment. In: Pol E, Fleury-Bahi G, Navarro O, editors. Handbook of Environmental Psychology and Quality of Life Research. Cham: Springer International Publishing; 2017. p. 421-440. doi:10.1007/978-3-319-31416-7_23.
  15. Driver C, Lovell GP, Oprescu F. Psychosocial strategies for physiotherapy: a qualitative examination of physiotherapists' reported training preferences. Nurs Health Sci. 2021;23(1):136-147. doi:10.1111/nhs.12771.
  16. Dunpath T, Chetty V, Van Der Reyden D. Acute burns of the hands - physiotherapy perspective. Afr Health Sci. 2016;16(1):266-275. doi:10.4314/ahs.v16i1.35.
  17. Elwyn G, Frosch D, Thomson R, Joseph-Williams N, Lloyd A, Kinnersley P, et al. Shared decision making: a model for clinical practice. J Gen Intern Med. 2012;27(10):1361-1367. doi:10.1007/s11606-012-2077-6.
  18. Epstein RM, Street RL. The values and value of patient-centered care. Ann Fam Med. 2011;9(2):100-103. doi:10.1370/afm.1239.
  19. Forsdyke D, Smith A, Jones M, Gledhill A. Psychosocial factors associated with outcomes of sports injury rehabilitation in competitive athletes: a mixed studies systematic review. Br J Sports Med. 2016;50(9):537-544. doi:10.1136/bjsports-2015-094850.
  20. Gallegos JS, Harris OD. Toward a model for the inclusion of ethnic minority content in doctoral social work education. J Educ Soc Work. 1979;15(1):29-35. doi:10.1080/00220612.1979.10671541.
  21. Gallegos JS, Tindall C, Gallegos SA. The need for advancement in the conceptualization of cultural competence. Adv Soc Work. 2018;9(1):51-62. doi:10.18060/214.
  22. Heywood S, Bunzli S, Dillon M, Bicchi N, Black S, Hemus P, et al. Trauma-informed physiotherapy and the principles of safety, trustworthiness, choice, collaboration, and empowerment: a qualitative study. Physiother Theory Pract. 2025;41(1):153-168. doi:10.1080/09593985.2024.2315521.
  23. Hutting N, Caneiro JP, Ong'wen OM, Miciak M, Roberts L. Person-centered care for musculoskeletal pain: putting principles into practice. Musculoskelet Sci Pract. 2022;62:102663. doi:10.1016/j.msksp.2022.102663.
  24. Hutting N, Caneiro JP, Ong'wen OM, Miciak M, Roberts L. Patient-centered care in musculoskeletal practice: key elements to support clinicians to focus on the person. Musculoskelet Sci Pract. 2022;57:102434. doi:10.1016/j.msksp.2021.102434.
  25. Jesus TS, Silva IL. Toward an evidence-based patient-provider communication in rehabilitation: linking communication elements to better rehabilitation outcomes. Clin Rehabil. 2016;30(4):315-328. doi:10.1177/0269215515585133.
  26. Johnson GM, Little R, Staufenberg A, McDonald A, Taylor KGM. How do they feel? Patients' perspectives on draping and dignity in a physiotherapy outpatient setting: a pilot study. Man Ther. 2016;26:192-200. doi:10.1016/j.math.2016.08.007.
  27. Johnson MI. An integral vision of pain and its persistence: a whole-person, whole-system, salutogenic perspective. Front Pain Res (Lausanne). 2025;6:1641571. doi:10.3389/fpain.2025.1641571.
  28. Joseph-Williams N, Edwards A, Elwyn G. Power imbalance prevents shared decision making. BMJ. 2014;348:g3178. doi:10.1136/bmj.g3178.
  29. Kelly JM, Bunzli S, Ritchie C, Kenardy J, Smeets R, Sterling M. Physiotherapist-delivered stress inoculation training for acute whiplash-associated disorders: a qualitative study of perceptions and experiences. Musculoskelet Sci Pract. 2018;38:30-36. doi:10.1016/j.msksp.2018.09.005.
  30. Khatri R, Endalamaw A, Erku D, Wolka E, Nigatu F, Zewdie A, et al. Continuity and care coordination of primary health care: a scoping review. BMC Health Serv Res. 2023;23(1):750. doi:10.1186/s12913-023-09718-8.
  31. Krohne K, Torres S, Slettebø Å, Bergland A. Individualizing standardized tests: physiotherapists' and occupational therapists' test practices in a geriatric setting. Qual Health Res. 2013;23(9):1168-1178. doi:10.1177/1049732313499073.
  32. Kurrus MB, Jewell VD, Gerardi S, Gerg M, Qi Y. Psychosocial factors addressed by occupational therapists in hand therapy: a mixed-methods study. J Hand Ther. 2023;36(3):632-640. doi:10.1016/j.jht.2022.07.006.
  33. Leggett H, Lister J, Hewitt C, Sharma H, McDaid C. Patients' and staffs' experiences of clinical support after a lower limb reconstruction: an interview study. Clin Rehabil. 2025;39(4):536-548. doi:10.1177/02692155251317500.
  34. Lewis H, Jinadu H, Kelley R, Medford N, Trigwell P, Guthrie E. Trust, belief and transitions: people's experiences of multidisciplinary inpatient treatment for persistent physical symptoms. A qualitative study. Disabil Rehabil. 2025;47(13):3342-3352. doi:10.1080/09638288.2024.2420833.
  35. Louw A, Schuemann T, Zimney K, Puentedura EJ. Pain neuroscience education for acute pain. Int J Sports Phys Ther. 2024;19(6):758-767. doi:10.26603/001c.118179.
  36. Marques LM, Battistella LR. Well-being as a core element of rehabilitation: preventing mental health challenges in a global context. Glob Health J. 2025;9(1):1-5. doi:10.1016/j.glohj.2025.02.004.
  37. Mescouto K, Olson RE, Hodges PW, Setchell J. A critical review of the biopsychosocial model of low back pain care: time for a new approach? Disabil Rehabil. 2022;44(13):3270-3284. doi:10.1080/09638288.2020.1851783.
  38. Middlebrook N, Heneghan NR, Moffatt M, Silvester L, Falla D, Rushton AB, et al. Experiences, views and perceptions of recovery following musculoskeletal trauma of patients and physiotherapists: a qualitative study. PLoS One. 2025;20(5):e0323575. doi:10.1371/journal.pone.0323575.
  39. Morera-Balaguer J, Botella-Rico JM, Martínez-González MC, Medina-Mirapeix F, Rodríguez-Nogueira Ó. Physical therapists' perceptions and experiences about barriers and facilitators of therapeutic patient-centred relationships during outpatient rehabilitation: a qualitative study. Braz J Phys Ther. 2018;22(6):484-492. doi:10.1016/j.bjpt.2018.04.003.
  40. Munn Z, Barker TH, Moola S, Tufanaru C, Stern C, McArthur A, et al. Methodological quality of case series studies: an introduction to the JBI critical appraisal tool. JBI Evid Synth. 2020;18(10):2127-2133. doi:10.11124/JBISRIR-D-19-00099.
  41. Nicholls DA, Atkinson K, Bjorbækmo WS, Gibson BE, Latchem J, Olesen J, et al. Connectivity: an emerging concept for physiotherapy practice. Physiother Theory Pract. 2016;32(3):159-170. doi:10.3109/09593985.2015.1137665.
  42. Peters MDJ, Godfrey C, McInerney P, Khalil H, Larsen P, Marnie C, et al. Best practice guidance and reporting items for the development of scoping review protocols. JBI Evid Synth. 2022;20(4):953-968. doi:10.11124/JBIES-21-00242.
  43. Petry Moecke D, Holyk T, Maddocks S, Campbell KL, Ho K, Camp PG. First nations peoples' perspectives on telehealth physiotherapy: a qualitative study focused on the therapeutic relationship. Rural Remote Health. 2024;24(4):9022. doi:10.22605/RRH9022.
  44. Purcell C, Fullen B, Walsh CB, Van Oirschot G, Ward T, Caulfield B. 'Another world of pain'—athlete and sport physiotherapist perspectives on the unique experience of pain in sport. BMJ Open Sport Exerc Med. 2024;10(3):e002020. doi:10.1136/bmjsem-2024-002020.
  45. Purcell C, Walsh CB, Van Oirschot G, Fullen BM, Ward T, Caulfield BM. Exploring athlete pain assessment experiences and priorities; a two-part qualitative series of athlete and physiotherapist interactions. Part Two. "Forging our future"—athlete and physiotherapists' priorities for pain assessment and beyond. J Sci Med Sport. 2025;28(3):170-178. doi:10.1016/j.jsams.2024.10.004.
  46. Reeves K, Job S, Blackwell C, Sanchez K, Carter S, Taliaferro L. Provider cultural competence and humility in healthcare interactions with transgender and nonbinary young adults. J Nurs Scholarsh. 2024;56(1):18-30. doi:10.1111/jnu.12903.
  47. Rizzato MMSA, Freitas LJ, Serenza FDS, de Oliveira AS. Empathy heals: patients' perception after an upper limb fracture and their experiences during and after the treatment discharge: a qualitative study. Disabil Rehabil. 2025:1-10. doi:10.1080/09638288.2025.2494730.
  48. Rosenbloom B, Khan F, McCartney CJ, Katz J. Systematic review of persistent pain and psychological outcomes following traumatic musculoskeletal injury. J Pain Res. 2013;6:39-51. doi:10.2147/JPR.S38878.
  49. Schroeder H, Israeli A, Liebergall M, Or O, Abu Ahmad W, Paltiel O, et al. Utilising patient-reported outcomes for goal-directed therapy of hip fracture patients: a sequential controlled trial. BMJ Open Qual. 2023;12(4):e002402. doi:10.1136/bmjoq-2023-002402.
  50. Silva Guerrero AV, Setchell J, Maujean A, Sterling M. "I've learned to look at things in a different way": exploring patients' perspectives on participation in physiotherapist delivered integrated stress inoculation training and exercise for acute whiplash. Disabil Rehabil. 2022;44(18):5191-5198. doi:10.1080/09638288.2021.1931480.
  51. Smart KM. The biopsychosocial model of pain in physiotherapy: past, present and future. Phys Ther Rev. 2023;28(2):61-70. doi:10.1080/10833196.2023.2177792.
  52. Smith-Forbes EV, Howell DM, Willoughby J, Armstrong H, Pitts DG, Uhl TL. Adherence of individuals in upper extremity rehabilitation: a qualitative study. Arch Phys Med Rehabil. 2016;97(8):1262-1268.e1. doi:10.1016/j.apmr.2015.11.008.
  53. Sole G, van Deventer A, Harris L, Wassinger C, Olds M. The "glass shoulder": patients' lived experiences of a traumatic shoulder dislocation—a qualitative study. Musculoskelet Sci Pract. 2024;73:103143. doi:10.1016/j.msksp.2024.103143.
  54. Street RL Jr, Makoul G, Arora NK, Epstein RM. How does communication heal? Pathways linking clinician-patient communication to health outcomes. Patient Educ Couns. 2009;74(3):295-301. doi:10.1016/j.pec.2008.11.015.
  55. Tricco AC, Lillie E, Zarin W, O'Brien KK, Colquhoun H, Levac D, et al. PRISMA extension for scoping reviews (PRISMA-ScR): checklist and explanation. Ann Intern Med. 2018;169(7):467-473. doi:10.7326/M18-0850.
  56. Tutton E, Gould J, Lamb SE, Costa ML, Keene DJ. Experience of patients and physiotherapists within the AFTER pilot randomised trial of two rehabilitation interventions for people aged 50 years and over post ankle fracture: a qualitative study. BMJ Open. 2023;13(7):e071678. doi:10.1136/bmjopen-2023-071678.
  57. Ulrich RS, Zimring C, Zhu X, DuBose J, Seo HB, Choi YS, et al. A review of the research literature on evidence-based healthcare design. HERD. 2008;1(3):61-125. doi:10.1177/193758670800100306.
  58. van den Boom NAC, Douwes I, Poeze M, Evers SMAA. Patient experiences and preferences during treatment and recovery of Lisfranc fractures: a qualitative interview study. Injury. 2022;53(12):4152-4158. doi:10.1016/j.injury.2022.10.013.
  59. Varela AJ, Gallamore MJ, Hansen NR, Martin DC. Patient empowerment: a critical evaluation and prescription for a foundational definition. Front Psychol. 2024;15:1473345. doi:10.3389/fpsyg.2024.1473345.
  60. von Aesch AV, Perry M, Sole G. Physiotherapists' experiences of the management of anterior cruciate ligament injuries. Phys Ther Sport. 2016;19:14-22. doi:10.1016/j.ptsp.2015.08.004.
  61. Wassinger CA, Edwards DC, Bourassa M, Reagan D, Weyant EC, Walden RR. The role of patient recovery expectations in the outcomes of physical therapist intervention: a systematic review. Phys Ther. 2022;102(4):pzac008. doi:10.1093/ptj/pzac008.
  62. Wortley K, Schellenberg BJ. Self-compassion and willingness to adhere to return-to-play protocol following sport-related concussions. J Sport Rehabil. 2024;34(3):242-248.
  63. Zackova M, Rucci P, Di Staso R, Ceretti S, Bonavina G, Delmestro E. Perceived relational empathy and resilience in people with spinal cord injury at the end of acute care: a cross-sectional study. Healthcare (Basel). 2024;12(16):1559. doi:10.3390/healthcare1216155.
Publish with JBRES — Peer-reviewed, multidisciplinary Open Access with rapid review, DOI, and global visibility.
Double-Blind CrossRef DOI Discoverable
Submit Manuscript Membership