The role of therapist-patient relationships in facilitating engagement and adherence in upper extremity rehabilitation

Authors

Katherine J. Loomis, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
Shawn C. Roll, Chan Division of Occupational Science and Occupational Therapy, University of Southern California, Los Angeles, CA, USA
Mark E. Hardison, Occupational Therapy Graduate Program, School of Medicine, University of New Mexico, Albuquerque, NM, USA

Document Type

Article

Publication Date

1-1-2023

Abstract

BACKGROUND: Active patient engagement and adherence are essential for successful rehabilitation outcomes, particularly in complex cases such as work-related musculoskeletal injuries. Although the therapist-patient relationship is a significant component of successful care coordination, there has been limited examination of this relationship within upper extremity musculoskeletal rehabilitation.

OBJECTIVE: To explore therapists' perspectives on how the therapist-patient relationship intersects with engagement and adherence in the provision of holistic and collaborative rehabilitation services.

METHODS: Data were collected from four therapists over three months. Descriptive statistics were generated from the Sport Injury Rehabilitation Adherence Scale (SIRAS) and the Rehabilitation Therapy Engagement Scale (RTES) completed by therapists following visits from a sub-sample of patients (n = 14). Weekly semi-structured group interviews (n = 13) were analyzed using an iterative grounded theory-informed process. Emerging themes were identified, refined, and situated within the context of quantitative results.

RESULTS: SIRAS scores averaged 14.4 (SD: 1.0) and RTES scores averaged 42.5 (SD: 3.5), indicating high perceived patient engagement and adherence. Four themes emerged from therapist interviews: (1) dynamic power; (2) co-constructed engagement; (3) emotional states; (4) complementary therapy contexts.

CONCLUSION: In this engaged and adherent setting, therapist-patient relationships were complex and intimate, and extended beyond education and physical interventions. Careful management of this relationship was central to active patient participation and engagement. Incorporating holistic techniques may provide more structure for managing and communicating these aspects of care. These findings provide a preliminary understanding of the impact of therapeutic relationships on engagement and collaborative care.

Publisher

IOS Press

Publication Title

Work (Reading, Mass.)

ISSN

1875-9270

Volume

76

Issue

3

First Page

1083

Last Page

1098

Recommended Citation

Loomis KJ, Roll SC, Hardison ME. The role of therapist-patient relationships in facilitating engagement and adherence in upper extremity rehabilitation. Work. 2023;76(3):1083-1098. doi: 10.3233/WOR-220384. PMID: 37248936.