The Influence of the Therapist-Patient Relationship on Treatment Outcome in Physical Rehabilitation: A Systematic Review

Hall, Amanda; Ferreira, Paulo H.; Maher, Christopher G.; Latimer, Jane; Ferreira, Manuela L

doi:10.2522/ptj.20090245

Cited by 504 publications

(376 citation statements)

References 33 publications

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“…A recent systematic review concluded that there is an association between therapeutic alliance and treatment outcomes in physical rehabilitation [7]. Therapeutic alliance is reportedly a multi-dimensional concept, including concepts such as rapport, trust, communication, empathy, mutual understanding, compassion and respect [4,5,7,8,10,11], causing difficulty in determining what aspect is responsible for the desired enhanced outcome, or what to measure. We would argue that the concept of 'empathy' is a distinct construct, which is important in the therapeutic alliance [12,13].…”

Section: Introductionmentioning

confidence: 99%

“…This is a missed opportunity, since there is now some evidence from empirical work that the relationship between clinicians and patients impacts not only on the satisfaction with healthcare but also on the outcomes of healthcare [3][4][5]. Whilst much of this research has been conducted to explore the relationship between doctors and patients, more recent studies are beginning to focus on the relationship between rehabilitation therapists and their patients [6][7][8][9]. A recent systematic review concluded that there is an association between therapeutic alliance and treatment outcomes in physical rehabilitation [7].…”

Section: Introductionmentioning

confidence: 99%

“…Whilst much of this research has been conducted to explore the relationship between doctors and patients, more recent studies are beginning to focus on the relationship between rehabilitation therapists and their patients [6][7][8][9]. A recent systematic review concluded that there is an association between therapeutic alliance and treatment outcomes in physical rehabilitation [7]. Therapeutic alliance is reportedly a multi-dimensional concept, including concepts such as rapport, trust, communication, empathy, mutual understanding, compassion and respect [4,5,7,8,10,11], causing difficulty in determining what aspect is responsible for the desired enhanced outcome, or what to measure.…”

Section: Introductionmentioning

confidence: 99%

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The consultation and relational empathy measure: an investigation of its scaling structure

Kersten

White

Tennant

2011

Disability and Rehabilitation

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The Consultation and Relational Empathy measure: an investigation of its scaling structure Abstract PurposeThe Consultation and Relational Empathy (CARE) measure is recommended to evaluate the quality of care. However, there is no evidence it is valid in rehabilitation. Aims 1) to examine the internal construct (factorial) validity of the CARE in the assessment of the patienttherapist relationship. MethodCARE data were part of an experimental study of acupuncture and different currently used acupuncture placebo controls, including 213 patients (age 66.8, SD 8.3, 58% female) with chronic stable hip or knee pain of mechanical origin, waiting for a joint replacement. CARE was completed two weeks into the study and on completion two weeks later. Data analysis:Cronbach alpha, factor analysis and Rasch analysis. ResultsInternal construct validity was supported (82% of variance explained by the first factor; fit to the Rasch model χ 2 =18.2, P=0.57). CARE was unidimensional, had local independence of items, good item fit, absence of Differential Item Functioning and invariance over time.Three percent of people did not complete items 9&10. ConclusionsCARE satisfied strict criteria for internal construct validity. An interval scale transformation is available that can be used in clinical practice and research. Further work is required to investigate item non-response and how this may be dealt with in clinical settings.3

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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The consultation and relational empathy measure: an investigation of its scaling structure

Kersten

White

Tennant

2011

Disability and Rehabilitation

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“…However, they were not specifically instructed or trained in behavior change techniques. Increasing evidence shows that the nature of the therapeutic relationship between the physiotherapist and the patient influences treatment adherence and clinical outcomes (24). Adherence is greater when practitioners are perceived as supportive rather than paternalistic (25).…”

mentioning

confidence: 99%

Effects of Two Physiotherapy Booster Sessions on Outcomes With Home Exercise in People With Knee Osteoarthritis: A Randomized Controlled Trial

Bennell

Kyriakides

Hodges

et al. 2014

Arthritis Care & Research

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Objective. Enhancing exercise adherence over the longer term is an important goal in self-management of knee osteoarthritis (OA). Following an initial period of more intensive exercise supervision, this study investigated whether 2 additional physiotherapy visits improved outcomes with continued home exercise over a subsequent 24-week period. Methods. A total of 78 people with medial knee OA (mean ؎ SD age 62.1 ؎ 6.9 years, mean ؎ SD body mass index 29.4 ؎ 4.0 kg/m 2 , and radiographic disease severity 19% mild, 49% moderate, and 32% severe) who completed a 12-week physiotherapist-supervised exercise trial were randomly allocated to 2 30-minute physiotherapy booster sessions (delivered by 8 physiotherapists in private clinics) or no booster sessions for the subsequent 24 weeks. All participants were asked to continue home exercises 4 times weekly. Primary outcomes were change in pain, using a 100-mm visual analog scale, and self-reported physical function, measured using the Western Ontario McMaster Universities Osteoarthritis Index. Participants and physiotherapists were unblinded to group allocation, although participants were blinded to the study hypothesis.

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“…Thus, a therapist-patient relationship of trust and safety is established, motivating the patient during treatment to achieve improvement in their pain (9) . One study demonstrated that commitment between patient and therapist correlates positively with treatment outcomes in physical rehabilitation programs, including: ability to perform daily life activities, pain, specific physical functional tasks, depression, global assessment of physical health, adherence to treatment and satisfaction with treatment (10) . In the pedagogical clinics connected to higher education institutions, where the attendance is carried out by students who are in the last year of undergraduate training under the supervision of Physiotherapy professors with, at least, a specialist title depending of the institution.…”

Section: Introductionmentioning

confidence: 99%

Patient Satisfaction Measurement by MedRisk Instrument

Guimarães¹,

Faria²,

Lima³

et al. 2020

mtprehabjournal

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Background:The importance of evaluating the user's perspective when dealing with the quality of health services has been a constant and the user's role as protagonist of this system has a direct impact on improving service. Thus, it is essential to know how users evaluate the care provided to rethink professional practices or intervene in the form of organization of services, to its improvement. Objectives: Assess the degree of patient satisfaction through MedRisk Instrument and identify the item that has the greatest impact on overall satisfaction. Methods/Design: The users of a university clinic of physical therapy, in rheumatology and pediatrics sectors, were asked about their degree of satisfaction, using MedRisk instrument. Results: Forty-six users completed the questionnaire. The 2 global measures means were 4,86 and 4,86 in rheumatology sector; and 4,76 and 4,84 in pediatrics sector. The specific items that had higher level of satisfaction and the highest correlation with overall satisfaction were items 6, 7, 8 and 11. Conclusion: The university physiotherapy clinic was assessed with a high degree of satisfaction to its users and items related to the therapist-patient interaction have more influence on overall satisfaction. Thus demonstrating that the MedRisk instrument is effective, functional and wide applicability.

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The Influence of the Therapist-Patient Relationship on Treatment Outcome in Physical Rehabilitation: A Systematic Review

Abstract: From this review, the alliance between therapist and patient appears to have a positive effect on treatment outcome in physical rehabilitation settings; however, more research is needed to determine the strength of this association.

Cited by 504 publications

References 33 publications

The consultation and relational empathy measure: an investigation of its scaling structure

The consultation and relational empathy measure: an investigation of its scaling structure

Effects of Two Physiotherapy Booster Sessions on Outcomes With Home Exercise in People With Knee Osteoarthritis: A Randomized Controlled Trial

Patient Satisfaction Measurement by MedRisk Instrument

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