Construction and content validation of a measurement tool to evaluate person-centered therapeutic relationships in physiotherapy services

Objectives: this study sought to develop a tool for evaluating person-centered therapeutic relationships within physiotherapy services, and to examine the content validity of the same. Methods: a mixed qualitative and quantitative study was performed in three distinct phases: 1) the items were generated based on a literature review and a content analysis of focus groups of patients and physiotherapists; 2) an e-Delphi survey process was performed based on three rounds to select and refine the proposed questionnaire; 3) two rounds of cognitive interviews were conducted to evaluate the comprehension of items, the clarity of language and the appropriateness and relevance of content. Results: thirty-one items were generated based on the seven domains identified after the analysis of four focus groups of physiotherapists and four patient focus groups. Nine experts participated in the e-Delphi survey. Fifty-five patients participated in the two rounds of the cognitive pre-tests. Participating patients were from public and private physical therapy services. Based on the participants' suggestions, four items were removed, and four were added, whereas 16 were reworded. Conclusions: the final tool comprised 31 items divided into seven domains. The response format was based on a 5-point Likert frequency scale. The response options ranged from "strongly agree" to "strongly disagree"

The psychometric properties of the person-centered therapeutic relationship in physiotherapy scale

[EN] Objective To determine the psychometric properties of the Person-Centered Therapeutic Relationship in Physiotherapy Scale (PCTR-PT) in order to find the most appropriate fit for the tool. Methods Patients who had received treatment at the physiotherapy service of nine hospitals in Spain were invited to complete the 31 items of the PCTR-PT scale. To select the most appropriate items of the PCTR-PT, an exploratory factorial analysis (EFA) was performed using the maximum likelihood and oblique rotation (promin) methods. Factor validity, goodness-of-fit and psychometric properties were analyzed by confirmatory factor analysis (CFA). Convergent (CFA) and discriminant validity were calculated. Internal consistency was verified using the Cronbach's alpha coefficient. The intraclass correlation coefficient (ICC) was used to examine temporal stability. Results 366 patients over 18 years old who had received, at least, 15 physiotherapy treatment sessions completed the questionnaire. The results of the exploratory factor analysis revealed a tool with 15 items in four factors [Relational Bond (N items = 4); Individualized Partnership (N items = 4); Professional Empowerment (N items = 3) and Therapeutic Communication (N items = 4)], explaining 78.4% of the variance of the total variables of this tool. The confirmatory factor analysis further confirmed the four-structure model. Reliability of the tool was approved by Cronbach's alpha in all four dimensions, as all were above .70, ranging from .84 (Individualized Partnership) to .91 (Professional Empowerment). = 0.94. Test-retest was performed with two-week intervals, indicating an appropriate stability for the scale (ICC = 0.900). Conclusion The Person-Centered Therapeutic Relationship in Physiotherapy Scale (PCTR-PT) is a useful, valid and applicable instrument to evaluate the person-centered therapeutic relationship during physiotherapy interventions. It would be interesting to investigate the predictive capacity (sensitivity and specificity) of the PCTR-PT scale.SIAuthors JMB, ORN, are recipients of a grant from CEU Cardenal Herrera University (www. uchceu.es) and the San Pablo University-Santander Foundation (FUSP). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript

The psychometric properties of the person-centered therapeutic relationship in physiotherapy scale

Objective: to determine the psychometric properties of the Person-Centered Therapeutic Relationship in Physiotherapy Scale (PCTR-PT) in order to find the most appropriate fit for the tool. Methods: patients who had received treatment at the physiotherapy service of nine hospitals in Spain were invited to complete the 31 items of the PCTR-PT scale. To select the most appropriate items of the PCTR-PT, an exploratory factorial analysis (EFA) was performed using the maximum likelihood and oblique rotation (promin) methods. Factor validity, goodness-of-fit and psychometric properties were analyzed by confirmatory factor analysis (CFA). Convergent (CFA) and discriminant validity were calculated. Internal consistency was verified using the Cronbach's alpha coefficient. The intraclass correlation coefficient (ICC) was used to examine temporal stability. Results: 366 patients over 18 years old who had received, at least, 15 physiotherapy treatment sessions completed the questionnaire. The results of the exploratory factor analysis revealed a tool with 15 items in four factors [Relational Bond (N items = 4); Individualized Partnership (N items = 4); Professional Empowerment (N items = 3) and Therapeutic Communication (N items = 4)], explaining 78.4% of the variance of the total variables of this tool. The confirmatory factor analysis further confirmed the four-structure model. Reliability of the tool was approved by Cronbach's alpha in all four dimensions, as all were above .70, ranging from .84 (Individualized Partnership) to .91 (Professional Empowerment). = 0.94. Test-retest was performed with two-week intervals, indicating an appropriate stability for the scale (ICC = 0.900). Conclusion: the Person-Centered Therapeutic Relationship in Physiotherapy Scale (PCTR-PT) is a useful, valid and applicable instrument to evaluate the person-centered therapeutic relationship during physiotherapy interventions. It would be interesting to investigate the predictive capacity (sensitivity and specificity) of the PCTR-PT scale

Usually hated, sometimes loved: A review of wild ungulates' contributions to people

Z.M.-R. was supported by a postdoctoral contract (APOSTD/2019/016) cofunded by the Generalitat Valenciana and the European Social Fund (ESF) , N.A.-A. by a pre-doctoral grant (BES-2016-077351) from the Spanish Ministry of Economy and Competitiveness (MINECO) and the ESF, E.S.-G. by the Generalitat Valenciana (SEJI/2018/024) and with a Ramon y Cajal research contract (RYC-2019-027216I) from the Spanish Ministry of Science and Innovation (MICINN) . M.M. was supported by a Ramon y Cajal research contract (RYC-2015-19231) from the MINECO. The study was partially supported by the Spanish Ministry of Science, Innovation and Universities and the European Regional Development Fund (ERDF) (Project "TRASCAR" RTI2018-099609-B-C21) .Nature's contributions to people (NCP) may be both beneficial and detrimental to humans' quality of life. Since our origins, humans have been closely related to wild ungulates, which have traditionally played an outstanding role as a source of food or raw materials. Currently, wild ungulates are declining in some regions, but recovering in others throughout passive rewilding processes. This is reshaping human-ungulate interactions. Thus, adequately under-standing the benefits and detriments associated with wild ungulate populations is necessary to promote human-ungulate co-existence. Here, we reviewed 575 articles (2000-2019) on human-wild ungulate interactions to identify key knowledge gaps on NCP associated with wild ungulates. Wild ungulate research was mainly distributed into seven research clusters focussing on: (1) silvicultural damage in Eurasia; (2) herbivory and natural vegetation; (3) conflicts in urban areas of North America; (4) agricultural damage in Mediterranean agro-ecosystems; (5) social research in Africa and Asia; (6) agricultural damage in North America; (7) research in natural American Northwest areas. Research mostly focused on detrimental NCP. However, the number of publications mentioning beneficial contributions increased after the Intergovernmental Science-Policy Platform on Biodiversity and Ecosystem Services conceptual framework was implemented. Human-ungulate interactions' research was biased towards the Global North and Cervidae, Suidae and Bovidae families. Regarding detrimental NCP, most publications referred to production damage (e.g. crops), followed by biodiversity damage, and material damage (e.g. traffic collisions). Regarding beneficial NCP, publications mainly highlighted non-material contributions (e.g. recreational hunting), followed by material NCP and regulating contributions (e.g. habitat creation). The main actions taken to manage wild ungulate populations were lethal control and using deterrents and barriers (e.g. fencing), which effectiveness was rarely assessed. Increasing research and awareness about beneficial NCP and effective management tools may help to improve the conservation of wild ungulates and the ecosystems they inhabit to facilitate people-ungulate co-existence in the Anthropocene.Generalitat Valenciana European Commission General Electric SEJI/2018/024European Social Fund (ESF)Spanish Ministry of Economy and Competitiveness (MINECO) BES-2016-077351European CommissionRamon y Cajal research contract from the Spanish Ministry of Science and Innovation (MICINN) RYC-2019-027216IMINECO RYC-2015-19231Spanish Ministry of Science, Innovation and Universities and the European Regional Development Fund (ERDF) RTI2018-099609-B-C21- APOSTD/2019/01

The influence of the environment on the patient-centered therapeutic relationship in physical therapy: a qualitative study

Abstract Background Currently, in the scientific literature there is a great interest on the study of strategies to implement patient-centered care. One of the main tools for this is the therapeutic relationship. Some studies suggest that the perception of the environment in which the treatment takes place can influence the perception of its quality, but this is not explored in physical therapy. For all these reasons, the aim of this study was to understand the influence of the environment in which physical therapy treatment takes place on the patients’ perception of the quality of the patient-centered therapeutic relationship in public health centers in Spain. Methods A qualitative study analysed thematically using a modified grounded theory approach. Data collection used semistructured interviewing during focus groups. Results We conducted four focus groups. The size of the focus groups ranged from six to nine participants. In total, 31 patients participated in these focus groups. Participants described a series of specific experiences and perceptions relating to the environment, which they felt were influential in the establishment of therapeutic patient-centered relationships, including six physical factors (Architectural barriers, Furniture, Use of the computer, Physical space, Ambiet conditions, and Privacy) and six organizational factors (Patient-physical therapist ratio, Treatment interruptions, Social factors, Continuity with the professional, Lack of professional autonomy, and Coordination or communication among team members). Conclusion The results of this study highlight environmental factors that affect the quality of the therapeutic patient-centered relationship in physical therapy from the patient’s point of view, and emphasize the need for physical therapists and administrators to underline the need to review these factors and take them into account in their service delivery