Abstract Background Musculoskeletal (MSK) pain conditions have a substantial influence on the quality of life. Psychosocial factors such as depression, anxiety and social isolation have been shown to play an important role in the development and management of MSK pain. Therefore, clinical practice guidelines commonly recommend adopting a biopsychosocial (BPS) framework by practitioners managing MSK pain. However, it remains unclear how osteopaths implement a BPS framework in the management of MSK pain. This protocol describes the objective and methods of a systematic review of barriers and facilitators experienced by osteopaths in implementing a BPS framework of care when managing people with MSK pain. Methods The following electronic databases from January 2005 to March 2019 will be searched: PubMed, AMED, EMBASE, CINAHL, Cochrane Library, Physiotherapy Evidence Database (PEDro), and SCOPUS. Two independent reviewers will review the title, abstract and full-text article retrieved from the databases to assess potentially eligible studies. Any studies (quantitative, qualitative and mixed methods) that investigated the use or application of the biopsychosocial approach in osteopathic practice will be included in the review. Data synthesis for qualitative studies will be done using the GRADE‐CERQual tool. Data synthesis methods for mixed method studies will be decided after data extraction and assessment. Discussion This systematic review will provide critical insights into the barriers and facilitators experienced by osteopaths to implement the BPS framework in their practice. This may be important and timely as a BPS framework has been recommended by various clinical practice guidelines.

中文翻译：

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整骨医生在管理肌肉骨骼疼痛患者时实施生物心理社会 (BPS) 护理框架时遇到的障碍和促进因素——混合方法系统审查协议

摘要 背景肌肉骨骼 (MSK) 疼痛状况对生活质量有重大影响。已证明抑郁、焦虑和社会孤立等社会心理因素在 MSK 疼痛的发展和管理中发挥重要作用。因此，临床实践指南通常建议管理 MSK 疼痛的从业者采用生物心理社会 (BPS) 框架。然而，目前尚不清楚整骨医生如何在 MSK 疼痛管理中实施 BPS 框架。该协议描述了系统审查整骨医生在管理 MSK 疼痛患者时实施 BPS 护理框架时遇到的障碍和促进因素的目标和方法。方法检索2005年1月至2019年3月以下电子数据库：PubMed、AMED、EMBASE、CINAHL、Cochrane Library、物理治疗证据数据库 (PEDro) 和 SCOPUS。两名独立审查员将审查从数据库中检索到的标题、摘要和全文文章，以评估可能符合条件的研究。任何调查生物心理社会方法在整骨疗法实践中的使用或应用的研究（定量、定性和混合方法）都将包含在审查中。定性研究的数据合成将使用 GRADE-CERQual 工具完成。混合方法研究的数据合成方法将在数据提取和评估后决定。讨论 本系统综述将对整骨医师在实践中实施 BPS 框架所遇到的障碍和促进因素提供重要见解。