Department of Physical Therapy Student Theses, Dissertations and Capstones

Document Type

Dissertation

Degree Name

Doctor of Philosophy (PhD) in Physical Therapy

Copyright Statement

All rights reserved. This publication is intended for use solely by faculty, students, and staff of Nova Southeastern University. No part of this publication may be reproduced, distributed, or transmitted in any form or by any means, now known or later developed, including but not limited to photocopying, recording, or other electronic or mechanical methods, without the prior written permission of the author or the publisher.

Department

College of Health Care Sciences - Physical Therapy Department

First Advisor

Emilio Puentedura

Second Advisor

Morey J Kolber

Third Advisor

Adriaan Louw

Publication Date / Copyright Date

2020

Publisher

Nova Southeastern University

Abstract

Background: Trust is a key component for developing therapeutic alliance. Improvements in trust have been found to improve outcomes forpatients receiving psychiatric and medical physician care. Current trust measurement scales have not been utilized in a physical therapy setting and no studies have explored the relation of trust in provider to physical therapy outcomes.

Purpose: The primary goal was to explore the correlation of patient trust measured at various points within the therapeutic encounter to the change in outcome measurements after receiving physical therapy care.

Research Design and Methods: Non-experimental correlational quantitative analysis of patient trust in their physical therapist as they received care for chronic and persistent low back pain. Participants (n = 30) completed three different trust measurement scales along with a general provider trust scale and therapeutic alliance measurement prior to initial visit, after initial visit, and at discharge. These scales were correlated to outcome measurements through the course of the encounter related to pain, function, and global improvement. Physical therapist measurement of patient connection and engagement was collected from physical therapist during episode of care.

Data Analysis: The Spearman rho correlation was utilized to provide correlational statistics for various trust measurement scales with therapeutic alliance scale, patient connection and engagement, and outcome measurement instruments. Linear regression was applied to individual trust measurement scales and outcome variables for predictive modeling of trust and outcomes. Results: Trust scores at discharge correlated the most with Global Rate of Change score and change in function at discharge (rs = 0.47–0.72). Change in trust score from post-initial visit to discharge provided the most correlation with pain scores at discharge and change of pain score (rs = 0.49–0.80). Trustmeasurement scores correlated strongly with therapeutic alliance scale (rs = 0.74–0.86) during the two measurement points.

Discussion: Higher levels of end trust scores showed strong correlation to improved function and global rate of change at discharge. The change in trust scores over treatment showed moderate to strong correlation with increasing trust to lower pain at discharge and greater improvements in change of pain.

Disciplines

Physical Therapy

Keywords

Chronic low back pain, Patient connection, Patient engagement, Physical therapy, Therapeutic alliance, Trust

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