Exploring the psychometric properties of the Working Alliance Inventory in general practice: a cross-sectional study

Liesbeth Hunik, Shelley Galvin, Tim olde Hartman, Elizabeth Rieger, Peter Lucassen, Kirsty Douglas, Pauline Boeckxstaens, Elizabeth Sturgiss

Research output: Contribution to journalArticleResearchpeer-review

3 Citations (Scopus)
2 Downloads (Pure)

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.

Original languageEnglish
Pages (from-to)1-9
Number of pages9
JournalBJGP Open
Volume5
Issue number1
DOIs
Publication statusPublished - Jan 2021
Externally publishedYes

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