Participants’ unspoken thoughts and feelings negatively influence the therapeutic alliance; a qualitative study in a multidisciplinary pain rehabilitation setting

Figures & data

Table 1. Characteristics of the participants (n = 26).

	Gender	Age in Years	Education^a	Duration of chronic pain in years	Working status	Disability status^b	CSI
Participant 1	Male	33	Middle	5	Reintegration into work	50	38
Participant 2	Female	24	Middle	4	Student	11	38
Participant 3	Male	21	Middle	2	Student	45	21
Participant 4	Female	33	Middle	3	Reintegration into work	14	35
Participant 5	Female	52	Low	9	Working	25	42
Participant 6	Female	55	Low	6	Not working	39	41
Participant 7	Female	33	High	2	Reintegration into work	24	37
Participant 8	Female	35	Low	6	Not working	53	52
Participant 9	Female	70	High	17	Retired	35	51
Participant 10	Male	46	Middle	3	Reintegration into work	7	34
Participant 11	Female	72	Middle	10	Not working	58	46
Participant 12	Male	64	High	10	Not working	37	43
Participant 13	Female	50	Low	16	Reintegration into work	27	60
Participant 14	Female	53	Low	20	Not working	43	52
Participant 15	Female	34	Middle	8	Working	36	50
Participant 16	Female	68	High	48	Retired	38	44
Participant 17	Female	28	Low	3	Not working	61	63
Participant 18	Female	28	High	10	Working	35	55
Participant 19	Male	36	Low	10	Working	46	41
Participant 20	Female	38	Low	25	Reintegration into work	38	42
Participant 21	Male	51	High	4	Working	45	21
Participant 22	Male	65	Middle	7	Retired	39	43
Participant 23	Female	45	Middle	4	Working	29	51
Participant 24	Female	62	High	4	Not working	37	31
Participant 25	Female	40	Low	4	Not working	37	52
Participant 26	Female	63	High	5	Not working	18	30

PDI: Pain Disability Inventory. CSI: Central Sensitization Inventory.

^aEducation level: Low, Middle, High. Low: primary school, lower secondary general education, lower vocational education; Middle: higher secondary general education, intermediate vocational education, High: Higher vocational education, university.

^bDisability status measured with the PDI. PDI range from 0 to 70, with higher scores reflecting higher interference of pain with daily activities. CSI range from 0-100, with higher scores indicating a higher probability of central sensitization.

Table 2. Difference between 2 healthcare professionals from participants’ perspectives (n = 26).

	Most positive		Least positive
WAI-ReD	Median	IQR 25;75	Median	IQR 25;75
Task	324.0	283.5; 363.0	292.0	223.0; 340.3
Goal	357.0	322.8; 380.8	335.0	286.0; 372.0
Bond	342.5	318.3; 366.8	332.5	292.0; 359.3
Total	1029.5	926.3; 1100.5	952.0	866.0; 1038.5

Each participant filled out the Working Alliance Inventory- Rehabilitation Dutch Version (WAI-ReD) for 2 healthcare professionals with whom they experienced the most positive and least positive therapeutic alliance, respectively. Domain scores range from 0 to 400 and total scores range from 0 to 1200; a higher score indicates a stronger therapeutic alliance with their healthcare professional. IQR: Inter Quartile Range.

Figure 1. Participants’ perceptions affecting engagement in the therapeutic alliance in pain rehabilitation program.