ISSN 2415-3060 (print), ISSN 2522-4972 (online)
  • 41 of 58
УЖМБС 2020, 5(6): 275–281
Physical Therapy and Ergotherapy

Comparison of the Therapeutic Alliance Indicators according to the Results of the Survey of Cardiosurgical Patients and their Physical Therapists

Vitomskyi V. V., Al-Hawamdeh K. M., Vitomska M. V., Gavreliuk S. V.

The purpose of the study was to determine and compare the indicators of the therapeutic alliance based on the results of a survey of cardiac surgery patients and their physical therapists. Material and methods. The survey involved 100 patients (over 18 years old, without cognitive impairment) who underwent cardiac surgery. The Working Alliance Inventory questionnaire was used to assess the level of therapeutic alliance formation. The SF Hatcher Client form (which consists of 12 questions) was used for the patient. These questions were divided into three groups / domains: "goal items", "task items" and "bond items". The questionnaire was filled in on the seventh postoperative day. The SF Hatcher Client form, which consisted of 12 questions, was used for the patient. Intervention: before surgery, patients received a short consultation with a physical therapist regarding the goals and content of physical therapy, the algorithm for activation after surgery; the postoperative physical therapy protocol included early mobilization, therapeutic gymnastics, the use of respiratory physical therapy techniques, and therapeutic walking under the supervision of a physical therapist. Patients were provided with information and tasks on therapeutic walking, a small set of therapeutic exercises and breathing physical therapy for independent implementation. Results and discussion. The indicators of the therapeutic alliance between physical therapists and cardiac surgery patients confirmed its high level, both according to the results of the questionnaire survey of patients and the results of the survey of specialists. The "goal items" domain had the highest score in the patient's assessment of therapeutic alliance. Since the patient and specialist questionnaires had a different number of questions and a different maximum score, it was decided to make comparisons of the overall estimates of the level of therapeutic alliance after converting them to a percentage of the maximum. A significantly better overall score for the therapeutic alliance was established according to the results of the questionnaire survey of physical therapists: 87.5 (82.5; 95) % of the maximum versus 81.25 (66.67; 89.58) % of the maximum (p = 0.000). Conclusion. Physical therapists rated the therapeutic alliance for a higher score

Keywords: physical therapy, cardiac surgery, cardiac rehabilitation, therapeutic exercises

Full text: PDF (Ukr) 343K

  1. Stewart MA. Effective physician-patient communication and health outcomes: a review. CMAJ: Canadian Medical Association Journal. 1995; 152(9): 1423-1433.
  2. Horvath AO, Symonds BD. Relation between working alliance and outcome in psychotherapy: A meta-analysis. Journal of counseling psychology. 1991; 38(2): 139.
  3. Martin DJ, Garske JP, Davis MK. Relation of the therapeutic alliance with outcome and other variables: a meta-analytic review. Journal of consulting and clinical psychology. 2000; 68(3): 438-450.
  4. 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.
  5. Hall MA, Zheng B, Dugan E, Camacho F, Kidd KE, Mishra A, et al. Measuring patients' trust in their primary care providers. Medical care research and review. 2002; 59(3): 293-318.
  6. 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.
  7. Kinney M, Seider J, Beaty AF, Coughlin K, Dyal M, Clewley D. The impact of therapeutic alliance in physical therapy for chronic musculoskeletal pain: A systematic review of the literature. Physiother Theory Pract. 2018; 28: 1-13.
  8. Taccolini Manzoni AC, Bastos de Oliveira NT, Nunes Cabral CM, Aquaroni Ricci N. The role of the therapeutic alliance on pain relief in musculoskeletal rehabilitation: A systematic review. Physiotherapy theory and practice. 2018; 34(12): 901-15.
  9. Vitomskyi VV, Lazarіeva ОB, Fedorenko SM, Vitomska MV. Methods of management and motivation in personnel management of the center of physical therapy and improving the quality of services for patients with orthopedic profile at the outpatient stage. Health, sport, rehabilitation. 2019; 2: 17-27.
  10. 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 & Research. 2019; 27: S303-4.
  11. Vitomskyi V. The impact of mobilization and other factors on pleural effusion in patients undergoing cardiac surgical procedures. Journal of Physical Education and Sport. 2020; 20 (Suppl 3): 2167-73.
  12. Vitomskyi VV, Al-Hawamdeh K, Lazarіeva О, Vitomskа M. The efficacy of using Tri-Ball breathing exerciser in respiratory function recovery of the patients undergoing cardiac surgery. Journal of Human Sport and Exercise. 2020; 17(2): 1-10.
  13. Horvath AO. Empirical validation of Bordin's pan theoretical model of the alliance: The Working Alliance Inventory perspective. In: AO Horvath, LS Greenberg, Eds. The working alliance: Theory, research and practice. NY: Wiley; 1994. p. 109-130.
  14. Munder T, Wilmers F, Leonhart R, Linster HW, Barth J. Working Alliance Inventory‐Short Revised (WAI‐SR): psychometric properties in outpatients and inpatients. Clinical psychology & psychotherapy. 2010; 17(3): 231-9.
  15. Ferreira PH, Ferreira ML, Maher CG, Refshauge KM, Latimer J, Adams RD. The therapeutic alliance between clinicians and patients predicts outcome in chronic low back pain. Physical therapy. 2013; 93(4): 470-8.
  16. Ferreira PH, Ferreira ML, Maher CG, Refshauge KM, Latimer J, Adams RD. The therapeutic alliance between physiotherapists and patients predicts outcome in chronic low back pain. In: International Forum X Primary Care Research on Low Back Pain; June 13-17, 2009. Boston, Massachusetts; 2009. 131 p.
  17. Zaproudina N, Hanninen OO, Airaksinen O. Effectiveness of traditional bone setting in chronic neck pain: randomized clinical trial. J Manipulative Physiol Ther. 2007; 30: 432-437.
  18. Zaproudina N, Hietikko T, Hanninen OO, Airaksinen O. Effectiveness of traditional bone setting in treating chronic low back pain: a randomised pilot trial. Complement Ther Med. 2009; 17: 23-28.
  19. Mirsky J. Anger expression, working alliance, and treatment outcome following multidisciplinary chronic pain treatment. In: Illinois Institute of Technology. Chicago, IL: Illinois Institute of Technology; 2002. 118 p.
  20. Higdon L. Patient Hostility, the Working Alliance, and Treatment Outcome in a Work Hardening Center. Chicago, IL: The Herman M. Finch University of Health Sciences, The Chicago Medical School; 1997. 120 p.
  21. Beattie P, Turner C, Dowda M, Michener L, Nelson R. The MedRisk Instrument for Measuring Patient Satisfaction With Physical Therapy Care: a psychometric analysis. J Orthop Sports Phys Ther. 2005; 35: 24-32.