Exploring the psychometric properties of the Working Alliance Inventory in general practice: a cross-sectional study
Date
2021
Authors
Hunik, Liesbeth
Galvin, Shelley
Olde Hartman, Tim
Rieger, Elizabeth
Lucassen, Peter
Douglas, Kirsty
Boeckxstaens, Pauline
Sturgiss, Elizabeth
Journal Title
Journal ISSN
Volume Title
Publisher
Royal College of General Practitioners
Abstract
Background: The therapeutic alliance is a framework from psychology that describes three components: goals, tasks, and bond. The Working Alliance Inventory adapted for general practice (WAI-GP) measures the strength of the therapeutic alliance between the patient and the clinician, and it could be useful in both research and clinical settings.
Aim: To determine if the patient score on WAI-GP can delineate the three components (goals, tasks, and bond), and to test concurrent validity with the Consultation and Relational Empathy (CARE) measure and the Patient Perception of Patient-Centredness (PPPC) measure.
Design & setting: A cross-sectional study took place in 12 general practice waiting rooms in Australia.
Method: The research instruments included the 12-item WAI-GP (the patient version), the CARE and PPPC measures, plus a survey of demographics and reason for consultation. To perform a principal components factor analysis of the WAI-GP, this dataset was combined with an existing dataset. The Spearman rank correlation was used to determine concurrent validity between the WAI-GP and the CARE and PPPC measures.
Results: Participants (97-99%) reported a strong positive alliance after the consultation (average WAI-GP mean 4.27 +- 0.67 out of 5, n = 146). Factor analysis could not separate the three components (one factor, eigenvalue >1; Cronbach’s α = 0.957; n = 281). Concurrent validity was supported by moderate correlations with the other measures (PPPC ρ = -0.51, P<0.005, CARE ρ = 0.56, P<0.005).
Conclusion: Three components could not be identified, but the WAI-GP has a high internal consistency and concurrent validity with moderate correlations with the CARE and PPPC. A more diverse sample may better distinguish the three components leading to more specific feedback to clinicians on their consultation practices.
Description
Keywords
Citation
Collections
Source
BJGP Open
Type
Journal article
Book Title
Entity type
Access Statement
Open Access
License Rights
Creative Commons Attribution License
Restricted until
Downloads
File
Description