Liesbeth Hunik1, Shelley Galvin2, Tim Olde Hartman1, Elizabeth Rieger3, Peter Lucassen1, Kirsty Douglas4, Pauline Boeckxstaens5, Elizabeth Sturgiss6. 1. Department of Primary and Community Care, Radboud University, Nijmegens, Netherlands. 2. UNC Health Sciences at MAHEC, Mountain Area Health Education Center, Asheville, United States. 3. Research School of Psychology, Australian National University Research School of Psychology, The Australian National University, Acton, Australia. 4. Academic Unit of General Practice, Australian National University Medical School, The Australian National University, Garran, Australia Academic Unit of General Practice, Australian National University Medical School, The Australian National University, Garran, Australia. 5. Department of Family Medicine and Primary Healthcare, Ghent University, Gent, Belgium. 6. Department of General practice, Monash University, Melbourne, Australia liz.sturgiss@monash.edu.
Abstract
BACKGROUND: Therapeutic alliance is a framework from psychology that describes three components: bond, task and goals. The Working Alliance Inventory adapted for general practice (WAI-GP), measures the strength of the therapeutic alliance between patient and clinician and could be useful in both research and clinical settings. AIM: To determine if the patient score on WAI-GP can delineate the three components and to test concurrent validity with the Consultation and Relational Empathy (CARE) and the Patient Perception of Patient-Centred (PPPC) measure. DESIGN AND SETTING: A cross-sectional study in twelve general practice waiting rooms in Australia. METHOD: The research instruments included the 12-item WAI-GP(patient), the CARE and PPPC measures plus a survey of demographics and reason for consultation. To perform a principal components factor analysis of the WAI-GP, we combined this dataset with an existing dataset. We used Spearmen correlations determined concurrent validity between the WAI-GP and the CARE and PPPC. RESULTS: Participants (97-99%) reported a strong positive alliance after the consultation (average WAI-GP mean 4.30 ± 0.62, out of 5,n=142). Factor analysis could not separate the three components (one factor, Eigen value >1; Cronbach's α=0.957;n=281). Concurrent validity was supported by moderate correlations with the other measures (PPPC rho=-0.51, P <0.005, CARE rho=0.56, P <0.005). CONCLUSIONS: We couldn't identify three components, but the WAI-GP has a high internal consistency and concurrent validity with moderate correlations with the CARE and PPPC. A more diverse sample may better distinguish the three components leading to more specific feedback to clinicians on their consultation practice.
BACKGROUND: Therapeutic alliance is a framework from psychology that describes three components: bond, task and goals. The Working Alliance Inventory adapted for general practice (WAI-GP), measures the strength of the therapeutic alliance between patient and clinician and could be useful in both research and clinical settings. AIM: To determine if the patient score on WAI-GP can delineate the three components and to test concurrent validity with the Consultation and Relational Empathy (CARE) and the Patient Perception of Patient-Centred (PPPC) measure. DESIGN AND SETTING: A cross-sectional study in twelve general practice waiting rooms in Australia. METHOD: The research instruments included the 12-item WAI-GP(patient), the CARE and PPPC measures plus a survey of demographics and reason for consultation. To perform a principal components factor analysis of the WAI-GP, we combined this dataset with an existing dataset. We used Spearmen correlations determined concurrent validity between the WAI-GP and the CARE and PPPC. RESULTS:Participants (97-99%) reported a strong positive alliance after the consultation (average WAI-GP mean 4.30 ± 0.62, out of 5,n=142). Factor analysis could not separate the three components (one factor, Eigen value >1; Cronbach's α=0.957;n=281). Concurrent validity was supported by moderate correlations with the other measures (PPPC rho=-0.51, P <0.005, CARE rho=0.56, P <0.005). CONCLUSIONS: We couldn't identify three components, but the WAI-GP has a high internal consistency and concurrent validity with moderate correlations with the CARE and PPPC. A more diverse sample may better distinguish the three components leading to more specific feedback to clinicians on their consultation practice.
Authors: Davy Paap; Yasmaine H J M Karel; Arianne P Verhagen; Pieter U Dijkstra; Jan H B Geertzen; Grieteke Pool Journal: Front Psychol Date: 2022-07-15