An exploration of clinical variables that enhance therapeutic alliance in patients seeking care for musculoskeletal pain: A mixed methods approach.
pain
physical therapy
therapeutic alliance
working alliance
Journal
Musculoskeletal care
ISSN: 1557-0681
Titre abrégé: Musculoskeletal Care
Pays: England
ID NLM: 101181344
Informations de publication
Date de publication:
09 2022
09 2022
Historique:
revised:
14
12
2021
received:
10
12
2021
accepted:
16
12
2021
pubmed:
6
1
2022
medline:
14
9
2022
entrez:
5
1
2022
Statut:
ppublish
Résumé
Therapeutic alliance (TA) is an integral part of building a patient and clinician relationship. TA begins at the initial encounter; however, the specific TA behavioural practices that are most impactful and linked to pain reduction and improved function remain unclear. The primary objective of this study was to explore physical therapist behaviours and interactions during the initial physical therapy evaluation and how they related to the patient's perception of TA. A secondary objective was to explore the relationship between TA, pain intensity, and function. A mixed methods study was conducted. Pain intensity, TA and self-reported function were assessed at three time points. Spearman's Rho (ρ) was used to quantify if there was an association between increased TA and function and reduced pain intensity, while a checklist of TA themes and behavioural practices was used for the qualitative analysis. There was a statistically significant negative correlation between patient-perceived TA and pain intensity immediately after the initial evaluation (ρ = -0.39 [p = 0.048]). Behavioural practices associated with higher TA included information gathering, pausing to listen, using humour and transitions, and use of clarifying questions. Behavioural practices associated with patient-perceived lower TA interactions were lack of touch, the absence of pain neuroscience education, and not restating what the patient said during the interview. This study highlights a relationship between TA and reduction of pain intensity after the initial evaluation and identifies key behavioural practices that could positively and negatively impact TA during the clinical encounter.
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
577-592Informations de copyright
© 2022 John Wiley & Sons Ltd.
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