DefinePK

Abstract

Background: In Pakistan, physiotherapy is often underutilized as a primary treatment modality due to limited public awareness and delayed patient engagement. Typically, patients seek physiotherapy only after medical referral and often exhibit uncertainty or mistrust toward their physiotherapists. Given the growing recognition of therapeutic alliance (TA) as a determinant of treatment success, this study aimed to explore the nature and strength of the therapeutic relationship within physiotherapy departments in hospitals based in Islamabad.
Objectives: To assess the perceived level of helping alliance among patients using the Helping Alliance Questionnaire-II (HAQ-II); to evaluate the correlation between patient and therapist responses on the HAQ-II; to determine the therapeutic working alliance using the Working Alliance Inventory–Short Revised (WAI-SR); and to explore the relationship between HAQ-II and WAI-SR scores.
Methods: This was a descriptive cross-sectional study involving 200 participants, including 150 patients and 50 physiotherapists, recruited through convenience sampling from hospitals in Islamabad. Inclusion criteria involved adults aged 18 years and above currently receiving physiotherapy care. Data were collected using two validated tools: the HAQ-II and WAI-SR. Descriptive statistics, Pearson and Spearman correlations, chi-square tests, and confidence interval analyses were used for statistical evaluation.
Results: The mean HAQ-II score for patients was 5.24 (SD = 0.564) and for therapists was 4.84 (SD = 0.548). Pearson correlation between versions was 0.090 (p = 0.535) and Spearman's rho was 0.128 (p = 0.374), both indicating weak, non-significant relationships. Chi-square values were significant for both patient (χ² = 71.040, df = 2, p < 0.001) and therapist versions (χ² = 81.520, df = 3, p < 0.001), showing differing perceptions. No significant distributional relationship was found between HAQ-II and WAI-SR (p = 0.981).
Conclusion: The study highlights the perceptual differences between patients and therapists regarding the therapeutic alliance, emphasizing the importance of integrating both perspectives to foster trust and improve physiotherapy outcomes.