Assessment of the therapeutic alliance in physical rehabilitation: a RASCH analysis
Assessment of the therapeutic alliance in physical rehabilitation: a RASCH analysis
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DOI：
10.3109/09638288.2011.606344
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发表时间：
2012-01-01
影响因子：
2.2
通讯作者：
Maher, Chris G.
中科院分区：
文献类型：
--
作者：
Hall, Amanda Marie;Ferreira, Manuela L.;Maher, Chris G.
目的：探讨工作联盟量表变化理论量表（WATOCI）在肢体康复中的心理测量学特性。方法：采用RASCH分析方法对16个条目的WATOCI进行效度、内部一致性、信度和区分度检验。数据来自一项随机对照试验，该试验采用WATOCI来衡量物理治疗师与慢性腰痛患者之间的联盟。结果：结果表明，16项WATOCI中有7项需要改进，以用于物理治疗环境。由此产生的9项版本的WATOCI被认为是一个一维的工具来衡量联盟，然而，表现出天花板效应。结论：WATOCI中有几个项目在临床实践中使用之前需要重新措辞和/或重新背景化。具体而言，项目更多的元素社会互动没有歧视，以及在这一人群中，一个解决方案可能是提供一个治疗特定的背景。关于患者对治疗目的的理解程度的项目在患者之间最佳区分，建议在工具评估中进一步开发这一领域。建议未来的研究在其用于临床环境之前解决这些问题。
Purpose: To investigate the psychometric properties of the Working Alliance Inventory Theory of Change Inventory (WATOCI) in physical rehabilitation. Methods: RASCH analysis was used to examine the validity, internal consistency, reliability and discriminative properties of the 16-item WATOCI. Data was obtained from a randomized controlled trial, which employed the WATOCI to measure the alliance between physical therapists and patients with chronic low back pain. Results: The results indicated that 7 items on the 16-item WATOCI should need to be improved for use in physiotherapy settings. The resulting 9-item version of the WATOCI was found to be a uni-dimensional tool for measuring alliance, however, demonstrated a ceiling effect. Conclusions: There are several items in the WATOCI that require re-wording and/or re-contextualization prior to its use in clinical practice. Specifically, items relating more to the element social interaction did not discriminate well in this population and one solution may be to provide a therapy-specific context. Items regarding how well the patient understood the purpose of the treatment discriminated best between patients and this area is recommended for further development in the tool's assessment. It is recommended that future research address these issues prior to its use in clinical settings.