Investigating the Influence of the Patient-Therapist Relationship on Adherence to Assistive Devices in Stroke Rehabilitation

Résumé

The patient therapist relationship (PTR) is a critical component of treatment delivery in health care settings. This construct has potential to inform treatment efficacy and adherence to assistive devices (ADs) in stroke rehabilitation. This study aimed to evaluate the significance of the PTR in promoting adherence to AD recommendations and identify barriers patients encounter in using ADs. Additionally, we investigated whether the Working Alliance Inventory-Short Revised (WAI-SR) questionnaire captured information about the PTR that could enhance adherence. Four therapists and four stroke patients participated in interviews centered on therapist roles, patient experiences, and approaches to enhance adherence. Therapists were asked to evaluate the WAI-SR’s ability to capture features of the PTR. Interviews were subject to thematic analysis. Therapists emphasized collaborative decision-making to enhance adherence, fostering trust and communication. Patients reported trusting their therapists, who played a major role in instilling confidence in AD use. Patient barriers included: stigma, education gaps, device design flaws, costs, and memory limitations. Insights from the WAI-SR provided valuable information on PTR dynamics, potentially enhancing adherence strategies. The findings suggest that the quality of the PTR significantly influences AD use. They offer insights into therapists' strategies for enhancing adherence, patients' barriers, and the WAI-SR’s potential.