The purpose of the study is to conduct intercultural adaptation of the questionnaires for the assessment of the therapeutic alliance, satisfaction with physical therapy in the Ukrainian language and verification of the validity and reliability of these versions of the tools. Materials and methods. The study involved 250 patients (32.4% – women; Me (25%; 75%) values of age 63 (56; 69) years) who underwent heart surgery on the basis of the State Institution "Scientific and Practical Medical Center for Pediatric Cardiology and Cardiac Surgery of the Ministry of Health of Ukraine” (Kyiv), as well as 10 employees of the Department of Physical Therapy and Occupational Therapy of the National University of Physical Education and Sport of Ukraine. Three tools were used in the work. The first one was the Working Alliance Inventory for the patient, namely the SR Hatcher Client form (WAI-SR-C). The Hatcher Therapist form (WAI-S-T), which consists of 10 items, was used for specialists (physical therapists). An adapted version questionnaire of the Scale patient satisfaction with physical therapy (SPSPT) adapted by Ampiah P. K. and co-authors was taken for translation into Ukrainian. The questionnaire includes 17 items. Results and discussion. The proposed versions of the questionnaires went through all stages of translation and intercultural adaptation, which meets international standards. A sufficient number of translators, a science editor and a group of patients were involved in the process to conduct cognitive interviews. The test of statistical hypotheses to confirm the content validity (including face validity) found sufficient relevance and completeness of the questions of all questionnaires, as all completed questionnaires did not contain blank items, and the minimum and maximum scores (floor and ceiling effects) for the overall score were less than 15%. A sufficient level of construct validity was also confirmed, as no differences were found in the overall scores of the questionnaires between the groups of patients who were formed by sex and age. At the same time, the verification of discriminant validity found that the items of all three questionnaires have a sufficiently high resolution property, and the instruments have a high discriminant validity. Ukrainian versions of the questionnaires have high levels of internal consistency, which indicates their reliability. The analysis of the results of the test-retest procedure confirmed the high reliability of the questionnaires. There are three factors in the structure of each tool. Conclusion. The developed Ukrainian versions of the questionnaires can be used to assess the level of therapeutic alliance and patient satisfaction in the field of physical therapy and occupational therapy

Keywords: physical therapy, occupational therapy, therapeutic exercises, therapeutic alliance, satisfaction, cardiac rehabilitation

Full text: PDF (Ukr) 544K

1. Vitomskyi V, Al-Hawamdeh K, Vitomska M, Lazarіeva O, Haidai O. The effect of incentive spirometry on pulmonary function recovery and satisfaction with physical therapy of cardiac surgery patients. Adv Rehab. 2021;35(1):9-16. https://doi.org/10.5114/areh.2020.102020
2. Vitomskyi V, Balazh M, Vitomska M, Lazarіeva O, Sokołowski D, Muszkieta R, et al. Effect of incentive spirometry and inspiratory muscle training on the formation of the therapeutic alliance between physical therapists and cardiac surgery patients. J Phys Educ Sport. 2021;21(4):1929-34.
3. Vitomskyi V, Balazh M, Vitomska M, Martseniuk I, Lazarіeva O. Assessment of the relationship between therapeutic alliance and pulmonary function recovery in cardiac surge ry patients undergoing physical therapy. Sport mont. 2021;19(S2):165-9.
4. Vitomskyi VV. Vplyv respiratornoho komponentu na zadovolenist fizychnoiu terapiieiu pislia kardiokhirurhichnykh vtruchan [The Influence of Respiratory Component on Satisfaction with Physical Therapy after Cardiosurgical Interventions]. Ukr ž med bìol sport. 2021;6(4):142-148. https://doi.org/10.26693/jmbs06.04.142
5. Crow R, Gage H, Hampson S, Hart J, Kimber A, Thomas H. The role of expectancies in the placebo effect and their use in the delivery of health care: a systematic review. Health Technology Assessment. 1999;3(3): 1-96. PMID: 10448203. https://doi.org/10.3310/hta3030
6. Fuentes J, Armijo-Olivo S, Funabashi M, Miciak M, Dick B, Warren S, et al. Enhanced therapeutic alliance modulates pain intensity and muscle pain sensitivity in patients with chronic low back pain: An experimental controlled study. Physical Therapy. 2014;94:477-489. PMID: 24309616. https://doi.org/10.2522/ptj.20130118
7. Bordin ES. Theory and Research on the Therapeutic Working Alliance: new Directions. In: Weiner IB, Series ed. The Working Alliance: theory, Research, and Practice. NY: Wiley; 1994. 13-37.
8. Bordin ES. The generalizability of the psychoanalytic concept of the working alliance. Psychotherapy: Theory, Research and Practice. 1979;16:252-260. https://doi.org/10.1037/h0085885
9. Paap D, Schrier E, Dijkstra PU. Development and validation of the Working Alliance Inventory Dutch version for use in rehabilitation setting. Physiother Theory Pract. 2019 Dec;35(12):1292-1303. PMID: 29733745. https://doi.org/10.1080/09593985.2018.1471112
10. Martin DJ, Garske JP, Davis MK. Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. J Consulting Clin Psychol. 2000;68(3):438-450. PMID: 10883561. https://doi.org/10.1037/0022-006X.68.3.438
11. Mercer SW, Maxwell M, Heaney D, Watt G. The consultation and relational empathy (CARE) measure: development and preliminary validation and reliability of an empathy-based consultation process measure. Family practice. 2004;21(6):699-705. PMID: 15528286. https://doi.org/10.1093/fampra/cmh621
12. Hall MA, Zheng B, Dugan E, Camacho F, Kidd KE, Mishra A, et al. Measuring patients' trust in their primary care providers. Med Care Res Rev. 2002;59(3):293-318. PMID: 12205830. https://doi.org/10.1177/1077558702059003004
13. Hall AM, Ferreira PH, Maher CG, Latimer J, Ferreira ML. The influence of the therapist-patient relationship on treatment outcome in physical rehabilitation: a systematic review. Physical therapy. 2010;90(8):1099-110. PMID: 20576715. https://doi.org/10.2522/ptj.20090245
14. Lawford B, Bennell KL, Campbell PK, Kasza J, Hinman RS. Therapeutic alliance between physiotherapists and patients with knee osteoarthritis consulting via telephone: a longitudinal study. Arthritis Care Res. 2019;27:S303-4. https://doi.org/10.1016/j.joca.2019.02.699
15. Cleary PD, McNeil BJ. Patient satisfaction as an indicator of quality care. Inquiry. 1988;25:25-36.
16. Hush JM, Cameron K, Mackey M. Patient satisfaction with musculoskeletal physical therapy care: a systematic review. Phys Ther. 2011;91(1):25-36. PMID: 21071504. https://doi.org/10.2522/ptj.20100061
17. Hush JM, Lee H, Yung V, Adams R, Mackey M, Wand BM, et al. Intercultural comparison of patient satisfaction with physiotherapy care in Australia and Korea: an exploratory factor analysis. J Man Manip Ther. 2013;21(2):103-112. PMID: 24421620. PMCID: PMC3649357. https://doi.org/10.1179/2042618613Y.0000000030
18. Hays RD, Larson C, Nelson EC, Batalden PB. Hospital quality trends: a short-form patient-based measure. Med Care. 1991;29:661-668. PMID: 2072771. https://doi.org/10.1097/00005650-199107000-00006
19. Marshall GN, Hays RD, Sherbourne CD, Wells KB. The structure of patient satisfaction with outpatient medical care. Psychol Assess. 1993;5:477-483. https://doi.org/10.1037/1040-3590.5.4.477
20. Ware JE Jr, Snyder MK, Wright WR, Davies AR. Defining and measuring patient satisfaction with medical care. Eval Program Plann. 1983;6:247-263. https://doi.org/10.1016/0149-7189(83)90005-8
21. Ampiah PK, Ahenkorah J, Karikari M. Patients' Satisfaction With Inpatient Orthopedic Physiotherapy Services at a Tertiary Hospital in Ghana. J Patient Experience. 2019;6(3):238-246. PMID: 31535013. PMCID: PMC6739682. https://doi.org/10.1177/2374373518793144
22. Casserley-Feeney SN, Phelan M, Duffy F, Roush S, Cairns MC, Hurley DA. Patient satisfaction with private physiotherapy for musculoskeletal pain. BMC Musculoskelet Disord. 2008;9:50. PMID: 18412974. PMCID: PMC2359748. https://doi.org/10.1186/1471-2474-9-50
23. Hills R, Kitchen S. Satisfaction with outpatient physiotherapy: focus groups to explore the views of patients with acute and chronic musculoskeletal conditions. Physiother Theory Pract. 2007;23(1):1-20. PMID: 17454795. https://doi.org/10.1080/09593980601023705
24. Hatcher RL, Gillaspy JA. Development and validation of a revised short version of the Working Alliance Inventory. Psychother Res. 2006;16(1):12-25. https://doi.org/10.1080/10503300500352500
25. Horvath AO. Empirical validation of Bordin's pan theoretical model of the alliance: The Working Alliance Inventory perspective. In: Horvath AO, Greenberg LS, Eds. The working alliance: Theory, research and practice. NY: Wiley; 1994. p. 109-130.
26. Munder T, Wilmers F, Leonhart R, Linster HW, Barth J. Working Alliance Inventory‐Short Revised (WAI‐SR): psychometric properties in outpatients and inpatients. Clin Psycholog Psychother. 2010;17(3):231-239. PMID: 20013760. https://doi.org/10.1002/cpp.658
27. Hatcher RL, Lindqvist K, Falkenström F. Psychometric evaluation of the working alliance inventory-therapist version: Current and new short forms. Psychother Res. 2020;30(6):706-717. PMID: 31621525. https://doi.org/10.1080/10503307.2019.1677964
28. Monnin D, Perneger TV. Scale to measure patient satisfaction with physical therapy. Physical Ther. 2002;82(7):682-691. PMID: 12088465. https://doi.org/10.1093/ptj/82.7.682
29. Vitomskyi VV, Al-Hawamdeh KM, Vitomska MV, Gavreliuk SV. Porivniannia pokaznykiv terapevtychnoho aliansu za rezultatamy anketuvannia kardiokhirurhichnykh patsiientiv ta yikh fizychnykh terapevtiv [Comparison of the Therapeutic Alliance Indicators according to the Results of the Survey of Cardiosurgical Patients and their Physical Therapists]. Ukr Ž Med Bìol Sport. 2020;5(6):275-281. https://doi.org/10.26693/jmbs05.06.275
30. Mokkink LB, Terwee CB, Patrick DL, Alonso J, Stratford PW, Knol DL, et al. The COSMIN study reached international consensus on taxonomy, terminology, and definitions of measurement properties for health-related patient-reported outcomes. J Clin Epidemiol. 2010 Jul 1;63(7):737-745. PMID: 20494804. https://doi.org/10.1016/j.jclinepi.2010.02.006
31. Pavlova IuO, Fedorovych OB, Perederiy AV, Tymruk-Skoropad KA. Rozroblennia ukrainskoi versii indeksu nepovnospravnosti Osvestri - mizhkulturna adaptatsiia ta validyzatsiia instrumenta [Development of the Ukrainian Version of Oswestry Disability Index - Intercultural Adaptation and Validation of the Tool]. UJMBS. 2021;4(31):300-309. [Ukrainian]. https://doi.org/10.26693/jmbs06.03.300
32. Dubina IN. Matematicheskie osnovy empiricheskih social'no-ekonomicheskih issledovanij: uchebnoe posobie [Mathematical foundations of empirical socio-economic research: textbook]. Barnaul: Publishing house Alt University; 2006. 263 p. [Russian]
33. Möller-Leimkühler AM, Dunkel R, Müller P, Pukies G, de Fazio S, Lehmann E. Is patient satisfaction a unidimensional construct? Eur Arch Psychiatry Clin Neurosci. 2002 Feb;252(1):19-23. PMID: 12056577. https://doi.org/10.1007/s004060200003
34. Baker R, Whitfield M. Measuring patient satisfaction: a test of construct validity. BMJ Quality Safety. 1992 Jun 1;1(2):104-109. PMID: 10172105. PMCID: PMC1054973. https://doi.org/10.1136/qshc.1.2.104
35. Chahal H, Mehta S. Modeling patient satisfaction construct in the Indian health care context. Int J Pharmaceut Healthcare Marketing. 2013 Mar 29;7(1):75-92. https://doi.org/10.1108/17506121311315445
36. Araujo AC, Filho RN, Oliveira CB, Ferreira PH, Pinto RZ. Measurement properties of the Brazilian version of the Working Alliance Inventory (patient and therapist short-forms) and Session Rating Scale for low back pain. J Back Musculoskelet Rehabil. 2017;30(4):879-887. PMID: 28282795. https://doi.org/10.3233/BMR-160563
37. Babatunde F, MacDermid J, MacIntyre N. Characteristics of therapeutic alliance in musculoskeletal physiotherapy and occupational therapy practice: a scoping review of the literature. BMC Health Serv Res. 2017 May 30;17(1):375. PMID: 28558746. PMCID: PMC5450083. https://doi.org/10.1186/s12913-017-2311-3
38. Paap D, Dijkstra PU. Working Alliance Inventory-Short Form Revised. J Physiother. 2017 Apr;63(2):118. PMID: 28336298. https://doi.org/10.1016/j.jphys.2017.01.001
39. Stinckens N, Ulburghs A, Claes L. De werkalliantie als sleutelelement in het therapiegebeuren. Meting met behulp van de WAV-12: de Nederlandse vertaling van de Working Alliance Inventory. Tijdschr Klin Psychol. 2009;39:44-60.
40. Takasaki H, Miki T, Hall T. Development of the Working Alliance Inventory-Short Form Japanese version through factor analysis and test-retest reliability. Physiother Theor Pract. 2020;36(3):444-449. PMID: 29913071. https://doi.org/10.1080/09593985.2018.1487492
41. Munder T, Wilmers F, Leonhart R, Linster HW, Barth J. Working Alliance Inventory‐Short Revised (WAI‐SR): psychometric properties in outpatients and inpatients. Clin Psychol Psychother. 2010 May;17(3):231-9. PMID: 20013760. https://doi.org/10.1002/cpp.658
42. Hsu S, Yu CK. A Hong Kong study of working alliance inventory short form-therapist. Asia Pacific J Counsel Psychother. 2017 Jul 3;8(2):87-100. https://doi.org/10.1080/21507686.2017.1313285