Article

OBJECTIVE: To synthesize qualitative studies exploring patients' and
professionals' perspectives and experiences of developing and maintaining
therapeutic alliances in stroke rehabilitation.
DATA SOURCES: A systematic
literature search was conducted using the following electronic databases:
PsycINFO, CINAHL, Embase, MEDLINE, Allied and Complementary Medicine Database,
Applied Social Sciences Index and Abstracts, and ComDisDome from inception to May
2014. This was supplemented by hand searching, reference tracking, generic web
searching, and e-mail contact with experts. STUDY SELECTION: Qualitative peer
reviewed articles reporting experiences or perceptions of the patient or
professional in relation to therapeutic alliance construction and maintenance in
stroke rehabilitation were selected for inclusion. After a process of exclusion,
17 publications were included in the synthesis. DATA EXTRACTION: All text
identified in the results and discussion sections of the selected studies were
extracted verbatim for analysis in a qualitative software program. Studies were
critically appraised independently by 2 reviewers. DATA SYNTHESIS: Articles were
synthesized using a technique of meta-ethnography. Four overarching themes
emerged from the process of reciprocal translation: (1) the professional-patient
relationship: degree of connectedness; (2) asymmetrical contributions; (3) the
process of collaboration: finding the middle ground; and (4) system drivers.
CONCLUSIONS: The findings from the meta-ethnography suggest that the balance of
power between the patient and professional is asymmetrically distributed in the
construction of the alliance. However, given that none of the studies included in
the review addressed therapeutic alliance as a primary research area, further
research is required to develop a conceptual framework relevant to stroke
rehabilitation, in order to determine how this construct contributes to treatment
efficacy.
CI - Copyright (c) 2016 American Congress of Rehabilitation Medicine. Published by
Elsevier Inc. All rights reserved.

Langue : ANGLAIS