Lambers Nicoline M, Bolton Jennifer E
Anglo-European College of Chiropractic, 13-15 Parkwood Road, Bournemouth, BH5 2DF UK.
Chiropr Man Therap. 2016 Jun 8;24:18. doi: 10.1186/s12998-016-0100-4. eCollection 2016.
Research in various medical fields demonstrates a consistent and positive association between clinical outcomes and the quality of the therapeutic alliance between the patient and clinician. The aim of this study was to explore how well chiropractors and their patients in The Netherlands perceive the quality of their working relationship.
A nationwide survey of chiropractors and their patients was conducted in The Netherlands, using a validated Dutch translation of the Working Alliance Inventory (WAV-12). Data were collected over a 5-week period in September-October 2014. Both patients and chiropractors were requested to reflect on 12 statements about to how well they perceived their collaboration in reaching consensus on treatment goals and treatment strategies, and how well they perceived the existence of an affective bond in their working relationship. A 5-point Likert scale was used to answer each question. Higher ratings reflected a more positive perception of the therapeutic alliance. Furthermore, levels of agreement between patients' and chiropractors' perceptions of the quality of their therapeutic alliance were determined.
In total, 207 working relationships between patients and their chiropractor were analysed. The quality of the therapeutic alliance was perceived as being very positive for both patients (n = 183, mean 49.14 ± 7.12) and chiropractors (n = 202, mean 50.48 ± 4.97). There was no difference in patients' perceptions whether treated by a male or female chiropractor, nor in relation to the chiropractor's years of experience. Nevertheless, poor agreement was found between perceptions of patients and chiropractors in the same relationship (ICC = 0.13).
Both patients and chiropractors perceived the quality of the therapeutic alliance as being very positive. Despite these positive results, patient and chiropractor pairs perceived the level of collaboration in order to reach agreement on treatment goals and strategies and the quality of their affective bond very differently. Clinically, these results suggest that chiropractors should, during the course of treatment, continue to collaborate with their patient and frequently verify whether their patient continues to agree with the treatment goals and treatment plan applied to further develop, improve and maintain a positive therapeutic alliance.
多个医学领域的研究表明,临床结果与患者和临床医生之间治疗联盟的质量存在一致且积极的关联。本研究的目的是探讨荷兰的脊椎按摩师及其患者对他们工作关系质量的认知程度。
在荷兰对脊椎按摩师及其患者进行了一项全国性调查,使用了经过验证的荷兰语翻译版工作联盟量表(WAV - 12)。数据于2014年9月至10月的5周内收集。患者和脊椎按摩师都被要求思考关于他们在就治疗目标和治疗策略达成共识方面的合作情况,以及他们对工作关系中情感纽带存在情况的认知程度的12条陈述。每个问题使用5点李克特量表回答。评分越高表明对治疗联盟的认知越积极。此外,还确定了患者和脊椎按摩师对治疗联盟质量的认知之间的一致程度。
总共分析了207对患者与脊椎按摩师的工作关系。患者(n = 183,均值49.14 ± 7.12)和脊椎按摩师(n = 202,均值50.48 ± 4.97)都认为治疗联盟的质量非常积极。患者对男性或女性脊椎按摩师治疗的认知没有差异,也与脊椎按摩师的从业年限无关。然而,同一关系中患者和脊椎按摩师的认知之间存在较差的一致性(组内相关系数 = 0.13)。
患者和脊椎按摩师都认为治疗联盟的质量非常积极。尽管有这些积极结果,但患者和脊椎按摩师对为就治疗目标和策略达成一致而进行的合作水平以及他们情感纽带的质量的认知差异很大。临床上,这些结果表明脊椎按摩师在治疗过程中应继续与患者合作,并经常核实患者是否继续同意所应用的治疗目标和治疗计划,以进一步发展、改善和维持积极的治疗联盟。