Measurement of Therapeutic Relationship in Physiotherapy

• Author / Creator

  McCabe, Erin

• The ‘therapeutic relationship’ refers to the relationship between a patient and their healthcare provider, which is assumed to be therapeutic when the quality of the relationship affects the well-being and clinical outcomes of treatment. In physiotherapy, therapeutic relationship can be thought of as encompassing the conditions established by the physiotherapist and patient through their intentions towards treatment, the patient and physiotherapist’s ways of connecting during clinical encounters, and the bond that develops between physiotherapist and patient. There is mounting physiotherapy evidence showing that therapeutic relationships can impact the degree to which the patient engages in treatment, as well as biomedical and psychosocial health outcomes such as self-efficacy, physical functioning, pain, satisfaction with treatment, depression, and general health status. Physiotherapy studies to date have used measures borrowed from psychotherapy. This is a problem because the relationship between a physiotherapist and patient differs from that in psychotherapy. The overall purpose of this dissertation is to develop a patient-reported measure of therapeutic relationship, based on a theoretical framework of therapeutic relationship in physiotherapy. This dissertation is comprised of a series of four papers, each building on the next, culminating in the evaluation of a physiotherapy-specific measure of therapeutic relationship – the Physiotherapy Therapeutic RElationship Measure (P-TREM). The first paper is a scoping review of the measures of therapeutic relationship and related constructs that have been used in research for patients with hemophilia. The second paper explores measurement theory in relation to therapeutic relationship in physiotherapy and summarized various approaches to measuring this complex, abstract phenomenon. The third paper outlines a study for the early development of the P-TREM, which included item generation, expert review, a content validation study and cognitive interviews. The fourth paper describes an evaluation of the validity of the P-TREM and optimizes its length. The end product is a 30-item version of the P-TREM which shows good concurrent and convergent validity, as well as internal consistency.

• Subjects / Keywords

  • Physiotherapy
  • Therapeutic relationship
  • Therapeutic alliance
  • Measurement
  • Assessment
  • Patient reported outcome measure
  • Patient-provider relationship

• Graduation date

  Spring 2022

• Type of Item

  Thesis

• Degree

  Doctor of Philosophy

• DOI

  https://doi.org/10.7939/r3-dhte-4853

• License

  This thesis is made available by the University of Alberta Libraries with permission of the copyright owner solely for non-commercial purposes. This thesis, or any portion thereof, may not otherwise be copied or reproduced without the written consent of the copyright owner, except to the extent permitted by Canadian copyright law.