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Dataset supporting the article: Mixed Methods Systematic Review of the Literature Base Exploring Working Alliance in the Chiropractic Profession
No full textDataset supporting the article by Ivanova, D., Bishop, F.L., Newell, D. et al. "Mixed methods systematic review of the literature base exploring working alliance in the chiropractic profession". Chiropractic & Manual Therapies 30, 35 (2022). https://doi.org/10.1186/s12998-022-00442-4
The data includes codebook and data extraction.
The data reviewed include the study aims, participants, methodology, methods of data collection, methods of analysis, key results, details about the research context, and information about the conceptualisation of the working alliance or its three features.
This research project synthesised a diverse body of evidence on the topic of working alliances using data from quantitative, qualitative, and mixed-methods studies. This type of systematic review provided a nuanced understanding of such a multifaceted phenomenon and was appropriate for the explorative objective of this study.
Abstract for the systematic literature review:
Background
The construct of working alliance has been used to operationalise the patient–clinician relationship. Research evidence from the rehabilitation literature has established an association between the construct and several patient outcomes. The aim of this systematic literature review was to study working alliance in the chiropractic discipline.
Method
This review followed a mixed method systematic review methodology: EBSCO (The Allied and Complementary Medicine Database), EBSCO (MEDLINE), EBSCO PsycINFO, Web of Science Core Collection, Chiro index, and grey literature were searched for quantitative, qualitative, and mixed methods studies on 17th March 2021. Qualitative appraisal was conducted using the Mixed Methods Appraisal Tool, version 2018. The qualitative component was synthesised via thematic synthesis and explored patients’ and chiropractors’ perceptions of the nature and role of working alliance. The quantitative component was synthesised via narrative synthesis to examine how the construct has been measured in research and what its effect on clinical outcomes and patient satisfaction is. The findings were integrated in the discussion section.
Results
Thirty studies were included. The qualitative component found that both patients and chiropractors consider working alliance as a key factor in the treatment journey. The findings illustrated that the construct includes the bond between a patient and a chiropractor which is underpinned by trust and attentiveness to patients’ needs, values and preferences. Qualitative data also suggested that strong working alliance has the potential to improve patients’ adherence to treatment and that it is characterised by ongoing negotiation of expectations about the goals of care and the tasks involved in the treatment plan. The quantitative component highlighted that even though working alliance is relevant to the chiropractic discipline, very few studies have quantitatively measured the construct and its effect.
Conclusion
The findings of this review emphasise the subjective importance of working alliance in the chiropractic clinical encounter. However, there were not enough homogenous studies measuring the effect of working alliance on clinical outcomes and patient satisfaction to conduct a meta-analysis. Future research should focus on evaluating potential direct and mediated effects on patient outcomes</span
Chiropractor-patient working alliance
No full textThe working alliance embodies the complex dynamics of the practitioner-patient relationship. Although the alliance has repeatedly been shown to predict clinical outcomes in musculoskeletal care, chiropractic research has given it relatively little attention. The three papers featured in this thesis delve into the chiropractor-patient alliance and aim to offer valuable insights for clinical practice, thereby making a unique contribution to the field. A mixed methods systematic review explored the alliance construct in the chiropractic literature. The quantitative synthesis found that few studies have measured the construct and its impact, with insufficient homogenous data for a meta-analysis. The qualitative synthesis suggests that chiropractic care can be considered a change process, where positive alliances ensure its cooperative nature. A qualitative study explored alliance formation at the start of care from the perspective of patients attending a teaching clinic. The early alliance involved a proces
The development of working alliance in early stages of care from the perspective of patients attending a chiropractic teaching clinic
No full textBackground: The clinician-patient relationship has consistently been found to predict treatment success in both physical and mental health settings. This relationship has been operationalised in the literature as "Working Alliance," which consists of three key components: patient-clinician agreement on the goals of care, agreement on the tasks required to achieve those goals, and the establishment of a strong bond. While research has demonstrated the impact of working alliance in physical health settings, it often measures working alliance early in patients' care journeys. However, no primary research has investigated how early working alliance develops between patients and chiropractors. Evidence suggests that musculoskeletal practitioners may require further training to feel confident in establishing working alliance. Therefore, this study aims to explore the development of working alliance in the early stages of chiropractic care from the patients' perspective to inform evidence-based practice.
Methods: Participants for this qualitative study were recruited from a teaching clinic at a specialised healthcare professions training university in the United Kingdom between September 2022 and April 2023. A total of 25 adult patients completed semi-structured interviews during the early stages of their care. The interview transcripts were analysed using Reflexive Thematic Analysis, from a critical realist stance.
Results: The findings highlight that an early working alliance entails the gradual development of patients' confidence in their decision to seek help from trainee chiropractors to alleviate their symptoms. The four themes describe the impact of the clinical context on patients' expectations, the trainee chiropractors' qualities that participants considered important for early working alliance, the role of explanations, and the interplay between pain and early working alliance.
Conclusions: Establishing an early trainee chiropractor-patient working alliance involves a process of building patients' confidence in the trainee chiropractors' expertise, identifying the correct goals of care, and recognising the value of the proposed treatment plan. Factors shaping this process include the context of the care journey, patients' perceptions of trainee chiropractors' qualities, their bodily sensations, their expectations, their past experiences, and their satisfaction with trainee chiropractors' explanations.
Keywords: Chiropractor-patient relationship; Confidence; Context; Expectations; Expertise; Explanations; Pain; Therapeutic Alliance; Trust; Working Alliance
Mixed methods systematic review of the literature base exploring working alliance in the chiropractic profession
No full textBackground: The construct of working alliance has been used to operationalise the patient–clinician relationship. Research evidence from the rehabilitation literature has established an association between the construct and several patient outcomes. The aim of this systematic literature review was to study working alliance in the chiropractic discipline. Method: This review followed a mixed method systematic review methodology: EBSCO (The Allied and Complementary Medicine Database), EBSCO (MEDLINE), EBSCO PsycINFO, Web of Science Core Collection, Chiro index, and grey literature were searched for quantitative, qualitative, and mixed methods studies on 17th March 2021. Qualitative appraisal was conducted using the Mixed Methods Appraisal Tool, version 2018. The qualitative component was synthesised via thematic synthesis and explored patients’ and chiropractors’ perceptions of the nature and role of working alliance. The quantitative component was synthesised via narrative synthesis to examine how the construct has been measured in research and what its effect on clinical outcomes and patient satisfaction is. The findings were integrated in the discussion section. Results: Thirty studies were included. The qualitative component found that both patients and chiropractors consider working alliance as a key factor in the treatment journey. The findings illustrated that the construct includes the bond between a patient and a chiropractor which is underpinned by trust and attentiveness to patients’ needs, values and preferences. Qualitative data also suggested that strong working alliance has the potential to improve patients’ adherence to treatment and that it is characterised by ongoing negotiation of expectations about the goals of care and the tasks involved in the treatment plan. The quantitative component highlighted that even though working alliance is relevant to the chiropractic discipline, very few studies have quantitatively measured the construct and its effect. Conclusion: The findings of this review emphasise the subjective importance of working alliance in the chiropractic clinical encounter. However, there were not enough homogenous studies measuring the effect of working alliance on clinical outcomes and patient satisfaction to conduct a meta-analysis. Future research should focus on evaluating potential direct and mediated effects on patient outcomes.</p
Going Beyond Counting First Authors in Author Co-citation Analysis
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sophisticated methods
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