Heredia-Callejón Alejandra, García-Pérez Patricia, Armenta-Peinado Juan Antonio, Infantes-Rosales Miguel Ángel, Rodríguez-Martínez María Carmen
Department of Physiotherapy, Faculty of Health Sciences, University of Malaga, 29071 Malaga, Spain.
Occupational Therapy Department, Hospital Marítimo, Servicio Andaluz de Salud (SAS), 29620 Malaga, Spain.
J Clin Med. 2023 Jun 26;12(13):4266. doi: 10.3390/jcm12134266.
The therapeutic alliance is a fundamental component of rehabilitation in order to achieve effective outcomes. However, what develops, maintains or hinders this relationship has not been sufficiently explored. The aim of this systematic review is to recognize the role of the therapeutic alliance in the neurological rehabilitation process. A search for articles was carried out in the databases PubMed, Web of Science, SCOPUS, CINAHL, APA PsycInfo, OTseeker and Dialnet. They were selected according to the eligibility criteria. Internal quality assessment of the articles was measured with the Consolidated Criteria for Reporting Qualitative Research (COREQ). The systematic review was registered in PROSPERO (ID 346523). The search in the databases identified 1596 articles, from which 9 different studies were finally included in the systematic review, reflecting the limitations of studies in this field. All studies are qualitative, from the point of view of the patients themselves, their relatives and healthcare professionals. The total sample of the included studies is 182 participants (96 health professionals, 76 users and 10 relatives). Semi-structured interviews, focus group discussions and written reflections were mainly used to collect the data. In conclusion, the therapeutic alliance can be an active component in the post-stroke rehabilitation process. Being recognized as a person, collaboration with the therapeutic team, empathy, empowerment, confidence, professional skills, maintenance of hope and the role of the family have been identified as aspects that can have an influence on the therapeutic alliance.
治疗联盟是康复治疗取得有效成果的一个基本组成部分。然而，对于促成、维持或阻碍这种关系的因素尚未进行充分探讨。本系统评价的目的是明确治疗联盟在神经康复过程中的作用。我们在PubMed、科学网、Scopus、护理学与健康领域数据库（CINAHL）、美国心理学会心理学文摘数据库（APA PsycInfo）、职业治疗师检索平台（OTseeker）和西班牙学术期刊数据库（Dialnet）中进行了文献检索。根据纳入标准对文献进行筛选。采用定性研究报告统一标准（COREQ）对文献进行内部质量评估。该系统评价已在国际前瞻性系统评价注册库（PROSPERO，注册号346523）登记。数据库检索共识别出1596篇文章，最终9项不同研究被纳入该系统评价，这也反映出该领域研究的局限性。所有研究均为定性研究，涉及患者本人、其亲属及医疗保健专业人员的观点。纳入研究的总样本量为182名参与者（96名医疗保健专业人员、76名使用者和10名亲属）。主要采用半结构式访谈、焦点小组讨论和书面反思来收集数据。总之，治疗联盟可以成为中风后康复过程中的一个积极组成部分。被视为一个个体、与治疗团队的协作、同理心、赋能、信心、专业技能、希望的维系以及家庭的作用，已被确定为可能影响治疗联盟的因素。
