Measuring therapeutic relationship in the care of patients with haemophilia: A scoping review

Abstract

ObjectiveWe conducted a scoping review of the tools used to measure therapeutic relationship in patients with haemophilia.BackgroundHaemophilia is an inherited bleeding disorder caused by a deficiency of a clotting factor in the blood. Therapeutic relationship is foundational to the management of patients with chronic diseases like haemophilia. A reliable and valid measurement tool for assessing therapeutic relationship is needed to evaluate the quality of care received by these patients, and to rigorously study the association between therapeutic relationship and the outcomes of treatment.MethodsWe adopted the Arksey and O'Malley framework for scoping studies. The following electronic databases were searched for studies that measured a construct related to therapeutic relationships in haemophilia care: MEDLINE, EMBASE, CINAHL, PsycINFO and Scopus. We inventoried these studies, identified the measurement tools used, and described each tool by purpose, content, measurement properties and target population. We identified gaps in the current evidence and directions for future research.ResultsThere were 253 unique records retrieved in the search, and twenty studies were deemed relevant. Ten measurement tools were identified. None of the tools measured therapeutic relationship as a single entity; however, six tools measured constructs considered part of patient‐provider relationship (eg trust, communication, working alliance). There has been little validation testing of these tools in haemophilia patient populations.ConclusionsThere is a need for a validated tool for measuring therapeutic relationship in the care of patients with haemophilia. This review provides a foundation for future research in this area.

Development of the Physiotherapy Therapeutic Relationship Measure

“…This allowed researchers to identify associations between therapeutic relationships and intermediate outcomes such as the degree to which the patient engages in physiotherapy treatment, self-efficacy, patient adherence to treatment, as well as biomedical and psychosocial health outcomes such as physical functioning, pain intensity, satisfaction with treatment, depression, and general health status [2,[4][5][6][7]. Researchers seeking to describe the therapeutic relationship in physiotherapy have found that while there are similarities with therapeutic relationship in psychotherapy, there are aspects unique to physiotherapy [8]. Specifically, in physiotherapy, the patient and physiotherapist often connect or relate through the patient's physical body, including connecting through physical contact (i.e.…”

Negotiating trust during times of uncertainty: haemophilia and AIDS

“…McCabe et al (2018) examined publications addressing haemophilia therapeutic relationships: e.g.Tran et al (2011). They identified two key gaps: connections over the physical body, which in haemophilia, is a major component; and second, the lack of consideration given to the theme of the 'personal' in the therapeutic relationship, the failure to address the deep personal and professional involvement of haemophilia physicians with their patients.74 For example, two studies examined the therapeutic relationship in other situations: primary care byPetrocchi et al (2019) and obstetrics by Diamond-Brown (2016).75 Fritz & Holton (2019) and Parker (2019) debated the issue of trust in patients and how they influence medical practice with an increase in defensive practice, including over-investigation.76 In their scoping review,Wilk and Platt (2016) raised crucial points that require addressing in measuring complex medical trust Thom et al (2011).…”