Patient- and Physical Therapist-Level Predictors of Patient-Reported Therapeutic Alliance: An Observational, Exploratory Study of Cohorts With Knee and Low Back Pain.
Arch Phys Med Rehabil
; 102(12): 2335-2342, 2021 12.
Article
em En
| MEDLINE
| ID: mdl-34283991
ABSTRACT
OBJECTIVE:
To identify patient- and physical therapist-level predictors for therapeutic alliance at the end of an episode of physical therapy for knee or low back pain (LBP).DESIGN:
Secondary analysis of observational cohort.SETTING:
Outpatient physical therapy clinics.PARTICIPANTS:
Patients receiving physical therapy for knee (n=189) or LBP (n=252) and physical therapists (n=19). Candidate predictor variables included demographics, patient clinical characteristics, and physical therapist attitudes and beliefs (Pain Attitudes and Beliefs Scale for Physical Therapists) and confidence in providing patient-centered care (Self-Efficacy in Patient-Centeredness Questionnaire).INTERVENTIONS:
Not applicable. MAIN OUTCOMEMEASURES:
Patient-reported therapeutic alliance was measured using the 12-item Work Alliance Inventory-Short Revised (WAI-SR).RESULTS:
Final linear mixed models indicated different patient- and physical therapist-level factor contributions in predicting final WAI-SR scores across cohorts with knee and LBP. Female sex was a consistent patient-level predictor for both knee (estimated ß=1.57, P<.05) and LBP (ß=1.42, P<.05), with age (ß=-0.07, P<.01) and baseline function (ß=0.06, P<.01) contributing to cohorts with knee and LBP, respectively. Physical therapist-level predictors included female sex (ß=6.04, P<.05), Pain Attitudes and Beliefs Scale for Physiotherapists behavioral (ß=0.65, P<.01), and Self-Efficacy in Patient-Centeredness Questionnaire (SEPCQ) Exploring Patient Perspective (ß=-0.75, P<.01) subscale scores for LBP, with SEPCQ Sharing Information and Power subscale scores (ß=0.56, P<.05) contributing to both cohorts with knee (ß=0.56, P<.05) and LBP (ß=0.74, P<.01). Random effects for patients nested within physical therapists were observed for both cohorts.CONCLUSIONS:
These findings provide preliminary evidence for inconsistent relationships among patient- and physical therapist-level factors and therapeutic alliance across cohorts with knee and LBP.Palavras-chave
Texto completo:
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Base de dados:
MEDLINE
Assunto principal:
Atitude do Pessoal de Saúde
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Modalidades de Fisioterapia
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Fisioterapeutas
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Aliança Terapêutica
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Traumatismos do Joelho
Tipo de estudo:
Etiology_studies
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Incidence_studies
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Observational_studies
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Prognostic_studies
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Qualitative_research
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Risk_factors_studies
Limite:
Adult
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Aged
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Female
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Humans
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Male
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Middle aged
Idioma:
En
Ano de publicação:
2021
Tipo de documento:
Article