Development and Validation of the AdT-Physio Scale: A Tool to Assess Adherence and Perception of Physical Therapist Intervention in Patients With Cystic Fibrosis

Abstract

Objective The purpose of this study was to develop a scale to measure patient adherence to physical therapist intervention and to report psychometric properties in patients with cystic fibrosis (CF). Methods This observational, multicenter, qualitative, and cross-sectional study was divided into 2 phases: development of scale items (content validity) and assessment of psychometric properties (construct validity, reliability, and convergent/discriminant validity). Recruited were 121 patients with CF (aged ≥16 y). Sociodemographic characteristics, lung function testing, Coping with Stress Self-Efficacy (EAEAE), brief Coping Orientation to Problems Experienced inventory (COPE-28), and the AdT-Physio scale were evaluated. Results The final version of the AdT-Physio scale consists of 15 items distributed across 2 subscales: compliance and beliefs about treatment/therapist. The scale showed high internal consistency (Cronbach α = 0.897; 95% CI = 0.868–0.922) and subscales above 0.800. The 2-factor confirmatory factor analysis model fitted the data reasonably well: χ2 (76) = 111.96, comparative fit index = 0.982, Tucker-Lewis index = 0.978, root mean square error of approximation = 0.063, 95% CI = 0.036 to 0.086, weighted root mean square residual = 0.720. No floor or ceiling effects were identified. There was a positive, significant, and moderate-low magnitude correlation with the total COPE-28 (r = .360) and EAEAE subscale efficacy expectations scores (r = .304). For discriminant validity, there was a positive, significant, and moderate correlation between the total and the age of the patients (r = .354). Conclusion The AdT-Physio scale is psychometrically valid and reliable for use in the clinic for the assessment of adherence to physiotherapy in patients with CF. Impact Ultimately, the authors propose this documentary instrument to assess the evaluation of the therapeutic alliance in a valid and objective manner. The AdT-Physio scale provides us with a greater degree of understanding of the problems behind noncompliance with treatment to advance person-centered decisions in physical therapy and thereby enhance the effectiveness of care.

Me, myself, and I: A systematic review of cystic fibrosis and self‐concept

“…Self‐efficacy refers to an individual's belief and confidence in their ability to undertake necessary behaviors to reach specific goals 52 . Within CF research these goals are predominantly related to physical health management, specifically adherence to the various aspects of CF treatment 21,25,26,33–37,43,44,53–56 . This is not surprising given MI was heavily embraced by CF care teams over the past decade as an effective counseling approach to improve CF treatment adherence 56 .…”

“…52 Within CF research these goals are predominantly related to physical health management, specifically adherence to the various aspects of CF treatment. 21,25,26,[33][34][35][36][37]43,44,[53][54][55][56] This is not surprising given MI was heavily embraced by CF care teams over the past decade as an effective counseling approach to improve CF treatment adherence. 56 MI aims to address ambivalence regarding treatment by promoting self-efficacy, confidence, sense-of-control and goalsetting.…”

“…21,25,26,[33][34][35][36][37]43,44,[53][54][55][56] This is not surprising given MI was heavily embraced by CF care teams over the past decade as an effective counseling approach to improve CF treatment adherence. 56 MI aims to address ambivalence regarding treatment by promoting self-efficacy, confidence, sense-of-control and goalsetting. 57 Interestingly, more recent studies focus on self-efficacy in relation to mental health management, specifically emotional regulation and psychological coping.…”

Psychological, Pain, and Disability Factors Influencing the Perception of Improvement/Recovery from Physiotherapy in Patients with Chronic Musculoskeletal Pain: A Cross-Sectional Study

“…After granting their consent to participate in the study, all participants were provided a set of questionnaires in the clinic before their treatment session, which included a sociodemographic questionnaire (age, sex, educational level, employment status, weight, and height). The participants also had to complete a number of self-reports to quantify the perception of change with regard to the physiotherapy they were undergoing, the level of disability and pain intensity using the Spanish version of the Graded Chronic Pain Scale (GCPS) [ 29 ], the level of fear of movement using the Tampa Scale of Kinesiophobia (TSK-11) [ 30 ], the level of catastrophism with the chronic pain catastrophism scale [ 31 ], the degree of self-efficacy with the Self-Efficacy in Chronic Pain questionnaire [ 32 ], the level of therapeutic alliance with the Therapeutic Alliance in Physiotherapy Questionnaire—Patients (CAF-P) [ 33 ] and the treatment adherence regarding physiotherapy [ 34 ]. The type of treatment and number of sessions received were registered by the assessors consulting the treatment notes of the patients.…”

“…Treatment adherence to the physiotherapy was assessed with the Treatment Adherence Scale (AdT). In its validation process, the scale showed excellent internal consistency (Cronbach’s α of 0.897) [ 34 ].…”