Lauren Greenberg1, Stephen Bremner2, Catherine Carr3, Stefan Priebe3. 1. Pragmatic Clinical Trials Unit, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK. 2. Department of Primary Care and Public Health, Brighton and Sussex Medical School, University of Brighton, Brighton, UK. 3. Unit for Social and Community Psychiatry, WHO Collaborating Centre for Mental Health Services Development, Queen Mary University of London, Newham Centre for Mental Health, London, UK.
Abstract
OBJECTIVES: Little attention has been given to the common assessment problem that clinicians assess outcomes of several patients and may rate them in comparison to one another, whereas patients assess only their own outcomes without any comparison. We explored empirically whether this would lead to a greater variability of clinician ratings as compared to patient ratings. METHODS: Data from two independent samples in which clinicians and patients, using consistent instruments, rated their therapeutic relationships. We present descriptive statistics of variability and intracluster correlation coefficients. RESULTS: The Helping Alliance Scale was completed at baseline and follow-up by 20 clinicians and 103 patients in an observational study and by 88 clinicians and 431 patients in a trial. Patients tended to rate their relationship 5-10% more highly than their clinicians, but with 50-100% more variability. Intraclinician Helping Alliance Scale ratings were more correlated than those by patients (intracluster correlation coefficients 0.3-0.7 vs. 0.0-0.2). CONCLUSION: Contrary to our assumption, clinicians' ratings of therapeutic relationships were in both samples less variable than those of their patients. When clinicians rate outcomes of several patients, a cluster effect of ratings may have to be considered in the design and analysis.
OBJECTIVES: Little attention has been given to the common assessment problem that clinicians assess outcomes of several patients and may rate them in comparison to one another, whereas patients assess only their own outcomes without any comparison. We explored empirically whether this would lead to a greater variability of clinician ratings as compared to patient ratings. METHODS: Data from two independent samples in which clinicians and patients, using consistent instruments, rated their therapeutic relationships. We present descriptive statistics of variability and intracluster correlation coefficients. RESULTS: The Helping Alliance Scale was completed at baseline and follow-up by 20 clinicians and 103 patients in an observational study and by 88 clinicians and 431 patients in a trial. Patients tended to rate their relationship 5-10% more highly than their clinicians, but with 50-100% more variability. Intraclinician Helping Alliance Scale ratings were more correlated than those by patients (intracluster correlation coefficients 0.3-0.7 vs. 0.0-0.2). CONCLUSION: Contrary to our assumption, clinicians' ratings of therapeutic relationships were in both samples less variable than those of their patients. When clinicians rate outcomes of several patients, a cluster effect of ratings may have to be considered in the design and analysis.
Authors: Rosemarie McCabe; Patrick G T Healey; Stefan Priebe; Mary Lavelle; David Dodwell; Richard Laugharne; Amelia Snell; Stephen Bremner Journal: Patient Educ Couns Date: 2013-07-12
Authors: Ulrich Reininghaus; Rosemarie McCabe; Mike Slade; Tom Burns; Tim Croudace; Stefan Priebe Journal: Psychiatry Res Date: 2013-02-27 Impact factor: 3.222
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