Stirane D1,2, Legzdina E1,2, Anaņjeva T2, Nulle A2
1Riga Stradins University, Riga, Latvia, 2National Rehabilitation Center 'Vaivari', Jurmala, Latvia
Background: Over the past few decades, the concept of person-centered care and patient-physician interaction has been intensively studied. Person-centered care elements (meeting the person´s needs, values or preferences; optimizing the person´s experiences with care; and fully involving persons´ perspectives into care) could be used in physiotherapy practice in persons with functional disability. The question, how the therapeutic process is ensured and how the relationship between the physiotherapist and persons with spinal cord injury is establish, has become important to construct the therapeutic alliance in person-centered care in physiotherapy practice.
Purpose: Purpose of this research study was to evaluate perceptions of therapeutic alliance in person-centered care in physiotherapy practice in persons with traumatic spinal cord injury.
Methods: In this quantitative, descriptive, cross-sectional study were included persons with spinal cord injury (n= 55) who received physiotherapy during initial rehabilitation in inpatient setting and agreed to participate in this research study and physiotherapists (n=5) who provide physiotherapy sessions for study involved persons with spinal cord injury. Study participants - persons with spinal cord injury completed The Helping Alliance Questionnaire (HAQ-II Luborsky et al., 1996) about their cooperation with physiotherapist (HAQ-II - service recipients or patient's version) and study participants-physiotherapists completed HAQ-II about their cooperation with patient (HAQ-II Physiotherapist's version) in physiotherapy sessions. The therapeutic alliance rated by physiotherapists and patients was assessed at first week in inpatient rehabilitation setting. To analyze cooperation between patient and physiotherapist there were pairs made - patient's questionnaire about his cooperation with physiotherapist and physiotherapist's questionnaire about his cooperation with patient.
Results: Assessment of perception of therapeutic alliance in person-centered care in physiotherapy practice shows good cooperation between study participants during physiotherapy. In general assessment of therapeutic alliance were more positive in the persons with spinal cord injury than physiotherapists (95.60 vs 89.78, P 0.05); Understanding the mutual cooperation during physiotherapy sessions reveals that participants of both study groups had a better understanding of professional values of physiotherapist, but shoved less understanding about the role of patient and their participation in the process of therapy and goal setting (P 0.05). Therapeutic alliance analyzed in pairs between physiotherapist and person with spinal cord injury during therapeutic relationship was more authoritative than person-centered in 13 pairs study participants (r≥0.5; P 0.05).
Conclusion(s): Persons with spinal cord injury and physiotherapists consider reciprocal reliance on cooperation in reaching goals, physiotherapist´s understanding of patient, patient´s confidence in physiotherapist judgment, and understanding of the nature of patient issues as important aspects of co-operation. Persons with spinal cord injury not always are sure about participation in the therapy process and goal setting.
Implications: Results can to enhance understanding of therapeutic alliance in person-centered care in physiotherapy practice. More work is needed on how the components of the therapeutic relationship evolve over time.
Keywords: Patient-centered care, Physiotherapy, Spinal cord injury
Funding acknowledgements: The study is funded by National Rehabilitation Center "Vaivari"
Purpose: Purpose of this research study was to evaluate perceptions of therapeutic alliance in person-centered care in physiotherapy practice in persons with traumatic spinal cord injury.
Methods: In this quantitative, descriptive, cross-sectional study were included persons with spinal cord injury (n= 55) who received physiotherapy during initial rehabilitation in inpatient setting and agreed to participate in this research study and physiotherapists (n=5) who provide physiotherapy sessions for study involved persons with spinal cord injury. Study participants - persons with spinal cord injury completed The Helping Alliance Questionnaire (HAQ-II Luborsky et al., 1996) about their cooperation with physiotherapist (HAQ-II - service recipients or patient's version) and study participants-physiotherapists completed HAQ-II about their cooperation with patient (HAQ-II Physiotherapist's version) in physiotherapy sessions. The therapeutic alliance rated by physiotherapists and patients was assessed at first week in inpatient rehabilitation setting. To analyze cooperation between patient and physiotherapist there were pairs made - patient's questionnaire about his cooperation with physiotherapist and physiotherapist's questionnaire about his cooperation with patient.
Results: Assessment of perception of therapeutic alliance in person-centered care in physiotherapy practice shows good cooperation between study participants during physiotherapy. In general assessment of therapeutic alliance were more positive in the persons with spinal cord injury than physiotherapists (95.60 vs 89.78, P 0.05); Understanding the mutual cooperation during physiotherapy sessions reveals that participants of both study groups had a better understanding of professional values of physiotherapist, but shoved less understanding about the role of patient and their participation in the process of therapy and goal setting (P 0.05). Therapeutic alliance analyzed in pairs between physiotherapist and person with spinal cord injury during therapeutic relationship was more authoritative than person-centered in 13 pairs study participants (r≥0.5; P 0.05).
Conclusion(s): Persons with spinal cord injury and physiotherapists consider reciprocal reliance on cooperation in reaching goals, physiotherapist´s understanding of patient, patient´s confidence in physiotherapist judgment, and understanding of the nature of patient issues as important aspects of co-operation. Persons with spinal cord injury not always are sure about participation in the therapy process and goal setting.
Implications: Results can to enhance understanding of therapeutic alliance in person-centered care in physiotherapy practice. More work is needed on how the components of the therapeutic relationship evolve over time.
Keywords: Patient-centered care, Physiotherapy, Spinal cord injury
Funding acknowledgements: The study is funded by National Rehabilitation Center "Vaivari"
Topic: Neurology: spinal cord injury; Neurology: spinal cord injury
Ethics approval required: Yes
Institution: Medical Ethical Committee
Ethics committee: Riga Stradins Unversity and National Rehabilitation Centre
Ethics number: 44/21.12.2017 and Nr. 04./12.17.
All authors, affiliations and abstracts have been published as submitted.
