Examining how medical practitioners establish therapeutic alliance : a dynamic systems approach
department or school: Health and Social Development, Faculty of (Okanagan)
department or school: Health and Exercise Sciences, School of (Okanagan)
data provider: DSpace
degree campus: UBCO
creator: Baxter, Kristy
issued: 2019-11-26T22:04:57Z
issued: 2019
related degree: Master of Science - MSc
degree grantor: University of British Columbia
description: Background: Patient-centred care is a key and understudied concept in modern health care. One notable influence on patient-centred care and patient outcomes, is therapeutic alliance. State space grids (SSGs) are an observational, dynamic systems methodology that allow for the trajectory of dyadic interactions to be mapped in real-time. By examining interactions between medical practitioners and patients, SSGs have the potential to characterize how therapeutic alliance is established in real-time. Objective: To use SSGs to examine how practitioners’ real-time use of verbal behaviours is associated with the perception of therapeutic alliance between a practitioner and a patient. Methods: This exploratory study involved video-recording practitioners having a simulated appointment (session) with a standardized patient. Following the sessions, therapeutic alliance was assessed using the Working Alliance Inventory (WAI). Analyses were conducted in three steps. In Step 1, WAI scores were calculated. In Step 2, a coding manual was developed to reliably code for verbal behaviours within the sessions. In Step 3, the coding manual was applied and SSG analyses were used to understand how practitioners and patients used verbal behaviours during the session, and if these behaviours were associated with WAI scores. Results: 11 practitioners participated in the study (55% men). The number of practitioner support statements were positively correlated with the patients’ WAI scores (p < .01). In contrast, the number of times the practitioner gave information was negatively correlated with the practitioners’ WAI scores (p < .05). The relationship between the number of transitions and WAI scores was negative (p > .05). Whereas, the average duration per visit was positively correlated with WAI scores (p > .05). Conclusions: Our findings highlight the importance of using a dynamic systems approach to understand how conversations between practitioners and patients unfold over time to influ…
aggregated CHO: https://circle.library.ubc.ca/rest/handle/2429/72419
note: EXAMINING HOW MEDICAL PRACTITIONERS ESTABLISH THERAPEUTIC ALLIANCE: A DYNAMIC SYSTEMS APPROACH by Kristy Baxter BHK, University of British Columbia Okanagan, 2017 A THESIS SUBMITTED IN PARTIAL FULFILLMENT OF THE REQUIREMENTS FOR THE DEGREE OF MASTER OF SCIENCE in THE COLLEGE OF GRADUATE STUDIES (Health and Exercise Sciences) THE UNIVERSITY OF BRITISH COLUMBIA (Okanagan) November 2019 © Kristy Baxter, 2019 ii The following individuals certify that they have read, and recommend to the College of Graduate Studies for acceptance, a thesis entitled: Examining How Medical Practitioners Establish Therapeutic Alliance: A Dynamic Systems Approach submitted by Kristy Baxter in partial fulfillment of the requirements of the degree of Master of Science Dr. Heather Gainforth, School of Health and Exercise Sciences, Faculty of Health and Social Development Supervisor Dr. Kathleen Martin Ginis, School of Health and Exercise Sciences, Faculty of Health and Social Development Supervisory Committee Member Dr. Karl Erickson, Department of Kinesiology, College of Education Supervisory Committee Member Dr. Brodie Sakakibara, Centre for Chronic Disease Prevention and Management, Faculty of Medicine University Examiner iii Abstract Background: Patient-centred care is a key and understudied concept in modern health care. One notable influence on patient-centred care and patient outcomes, is therapeutic alliance. State space grids (SSGs) are an observational, dynamic systems methodology that allow for the trajectory of dyadic interactions to be mapped in real-time. By examining interactions between medical practitioners and patients, SSGs have the potential to characterize how therapeutic alliance is established in real-time. Objective: To use SSGs to examine how practitioners’ real-time use of verbal behaviours is associated with the perception of therapeutic alliance between a practitioner and a patient. Methods: This exploratory study involved video-recording practitioners having a simul…
has type: Thesis/Dissertation
date issued: 2019-11
is shown at: 10.14288/1.0385977
language: eng
degree discipline: Health and Exercise Sciences
provider: Vancouver : University of British Columbia Library
publisher: University of British Columbia
rights: Attribution-NoDerivatives 4.0 International
rights URI: http://creativecommons.org/licenses/by-nd/4.0/
scholar level: Graduate
type: Text
identifier URI: http://hdl.handle.net/2429/72419