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An exploration of clinical variables that enhance therapeutic alliance in patients seeking care for musculoskeletal pain: A mixed methods approach.

Publication ,  Journal Article
Myers, C; Thompson, G; Hughey, L; Young, JL; Rhon, DI; Rentmeester, C
Published in: Musculoskeletal Care
September 2022

INTRODUCTION/OBJECTIVES: Therapeutic alliance (TA) is an integral part of building a patient and clinician relationship. TA begins at the initial encounter; however, the specific TA behavioural practices that are most impactful and linked to pain reduction and improved function remain unclear. The primary objective of this study was to explore physical therapist behaviours and interactions during the initial physical therapy evaluation and how they related to the patient's perception of TA. A secondary objective was to explore the relationship between TA, pain intensity, and function. METHODS: A mixed methods study was conducted. Pain intensity, TA and self-reported function were assessed at three time points. Spearman's Rho (ρ) was used to quantify if there was an association between increased TA and function and reduced pain intensity, while a checklist of TA themes and behavioural practices was used for the qualitative analysis. RESULTS: There was a statistically significant negative correlation between patient-perceived TA and pain intensity immediately after the initial evaluation (ρ = -0.39 [p = 0.048]). Behavioural practices associated with higher TA included information gathering, pausing to listen, using humour and transitions, and use of clarifying questions. Behavioural practices associated with patient-perceived lower TA interactions were lack of touch, the absence of pain neuroscience education, and not restating what the patient said during the interview. CONCLUSION: This study highlights a relationship between TA and reduction of pain intensity after the initial evaluation and identifies key behavioural practices that could positively and negatively impact TA during the clinical encounter.

Duke Scholars

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Published In

Musculoskeletal Care

DOI

EISSN

1557-0681

Publication Date

September 2022

Volume

20

Issue

3

Start / End Page

577 / 592

Location

England

Related Subject Headings

  • Therapeutic Alliance
  • Self Report
  • Professional-Patient Relations
  • Pain Measurement
  • Musculoskeletal Pain
  • Humans
  • Arthritis & Rheumatology
  • 4205 Nursing
  • 1110 Nursing
 

Citation

APA
Chicago
ICMJE
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Myers, C., Thompson, G., Hughey, L., Young, J. L., Rhon, D. I., & Rentmeester, C. (2022). An exploration of clinical variables that enhance therapeutic alliance in patients seeking care for musculoskeletal pain: A mixed methods approach. Musculoskeletal Care, 20(3), 577–592. https://doi.org/10.1002/msc.1615
Myers, Christina, Glenn Thompson, Lindsey Hughey, Jodi L. Young, Daniel I. Rhon, and Casey Rentmeester. “An exploration of clinical variables that enhance therapeutic alliance in patients seeking care for musculoskeletal pain: A mixed methods approach.Musculoskeletal Care 20, no. 3 (September 2022): 577–92. https://doi.org/10.1002/msc.1615.
Myers C, Thompson G, Hughey L, Young JL, Rhon DI, Rentmeester C. An exploration of clinical variables that enhance therapeutic alliance in patients seeking care for musculoskeletal pain: A mixed methods approach. Musculoskeletal Care. 2022 Sep;20(3):577–92.
Myers, Christina, et al. “An exploration of clinical variables that enhance therapeutic alliance in patients seeking care for musculoskeletal pain: A mixed methods approach.Musculoskeletal Care, vol. 20, no. 3, Sept. 2022, pp. 577–92. Pubmed, doi:10.1002/msc.1615.
Myers C, Thompson G, Hughey L, Young JL, Rhon DI, Rentmeester C. An exploration of clinical variables that enhance therapeutic alliance in patients seeking care for musculoskeletal pain: A mixed methods approach. Musculoskeletal Care. 2022 Sep;20(3):577–592.
Journal cover image

Published In

Musculoskeletal Care

DOI

EISSN

1557-0681

Publication Date

September 2022

Volume

20

Issue

3

Start / End Page

577 / 592

Location

England

Related Subject Headings

  • Therapeutic Alliance
  • Self Report
  • Professional-Patient Relations
  • Pain Measurement
  • Musculoskeletal Pain
  • Humans
  • Arthritis & Rheumatology
  • 4205 Nursing
  • 1110 Nursing