Validity of the Flemish working alliance inventory in a Dutch physiotherapy setting in patients with shoulder pain

ABSTRACT

Background: Working alliance is the interaction between the patient and therapist. It is a crucial part of the physiotherapeutic process. One instrument to measure working alliance is available in Dutch/Flemish language and validated in psychotherapy setting. Objective: This study aims to validate the Working Alliance Inventory Short-Form in a Dutch physiotherapy setting. Design: A prospective cohort study in primary-care physiotherapy. Method: To validate the Dutch/Flemish version of the working alliance inventory short-form (WAV-12) a RASCH analysis was used. Results: Sixty-six physiotherapists enrolled in total 389 patients with an average age of 50 years and a mean duration of shoulder pain of 33 weeks. A total of 274 patients filled in one or more items of the WAV-12. The WAV-12 showes good discriminative abilities and all items contributed to a one-dimensional construct. Due to the selective nature of the missing items, we believed rewording was necessary to make it more suitable to the physiotherapy setting. We performed a Delphi study and revised the WAV-12 into the PAS (Physio Alliance Scale). The validity of the revised version is unknown and is therefore not sufficiently strong to be implemented as a measurement tool. Limitations: The response rate for three items especially was low and we found ceiling effects in ten items. Conclusion: Although the measurement instrument shows good internal consistency and reliability, we made adjustments to the WAV-12 for Dutch physiotherapy setting.

KEYWORDS:

• Working alliance
• therapeutic alliance
• rasch analysis
• WAV-12
• physiotherapy
• physician-patient relations

Acknowledgments

We thank the Delphi panel and Davy Paap for contributing to the adjustments of the questionnaire.

Declaration of interest

The authors report no declarations of interest.

Funding

This study is financed by the SIA-RAAK grant. The ministry of education has made this funding available for the innovation and promotion of research. This study is partly funded by a program grant of the Dutch Arthritis Foundation.

Additional information

Funding

This study is financed by the SIA-RAAK grant. The ministry of education has made this funding available for the innovation and promotion of research. This study is partly funded by a program grant of the Dutch Arthritis Foundation.