title: Assessment of the therapeutic alliance in physical rehabilitation: a RASCH analysis.
abstract: OBJECTIVE
  To investigate the psychometric properties of the Working Alliance Inventory Theory of Change Inventory (WATOCI) in physical rehabilitation.
  
  
  METHODS
  RASCH analysis was used to examine the validity, internal consistency, reliability and discriminative properties of the 16-item WATOCI. Data was obtained from a randomized controlled trial, which employed the WATOCI to measure the alliance between physical therapists and patients with chronic low back pain.
  
  
  RESULTS
  The results indicated that 7 items on the 16-item WATOCI should need to be improved for use in physiotherapy settings. The resulting 9-item version of the WATOCI was found to be a uni-dimensional tool for measuring alliance, however, demonstrated a ceiling effect.
  
  
  CONCLUSIONS
  There are several items in the WATOCI that require re-wording and/or re-contextualization prior to its use in clinical practice. Specifically, items relating more to the element social interaction did not discriminate well in this population and one solution may be to provide a therapy-specific context. Items regarding how well the patient understood the purpose of the treatment discriminated best between patients and this area is recommended for further development in the tool's assessment. It is recommended that future research address these issues prior to its use in clinical settings.
authors: Musculoskeletal Division, The George Institute for Global Health, Sydney, Australia. amandahall@georgeinstitute.org.au
authors: Amanda Marie
authors: AM
authors: Hall
authors: Manuela L
authors: ML
authors: Ferreira
authors: Lindy
authors: L
authors: Clemson
authors: Paulo
authors: P
authors: Ferreira
authors: Jane
authors: J
authors: Latimer
authors: Chris G
authors: CG
authors: Maher
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001315:Australia; D002908:Chronic Disease; D005260:Female; D006801:Humans; D017116:Low Back Pain / Q000534:rehabilitation*; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D059825:Physical Therapists; D025341:Principal Component Analysis; D011369:Professional-Patient Relations; D011594:Psychometrics / Q000295:instrumentation*; D016032:Randomized Controlled Trials as Topic; D015203:Reproducibility of Results; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D055815:Young Adult