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The therapeutic relationship in remote support for self management of chronic dizziness

The therapeutic relationship in remote support for self management of chronic dizziness
The therapeutic relationship in remote support for self management of chronic dizziness
Telephone-delivered therapy is often used to deliver support as it can help overcome barriers that may previously have prevented patients with chronic illness from accessing key services. Very little research has looked at the therapeutic relationship during telephone support for people self-managing a chronic illness. the empirical work in this thesis is nested within a randomised controlled trial (RCT) of self-management of chronic dizziness, a condition that can be debilitating with serious consequences. This thesis explored the role of the therapeutic relationship during telephone support for using booklet-based vestibular rehabilitation (VR) to self-manage chronic dizziness.

A meta-analysis of telephone delivered therapy for chronic illness was conducted to examine whether or not telephone therapy can affect physical health outcomes. Eight RCTs (1093 patients) were included, and the results found that telephone delivered therapy significantly improved physical health outcomes in people with chronic illness (d = 0.225, 95% Cl = 0.105, 0.344). A qualitative study of people's experiences of self-managing chronic dizziness using booklet-based VR with or without telephone support (n=33) identified themes characterising people's experiences, thoughts and feelings about these models of VR delivery. Findings indicated that participants valued telephone support. Quantitative analysis examining predicators of outcome (n=112) found that the therapeutic relationship predicted change in handicap, and was related to greater enablement, although it was not related to change in dizziness symptoms. A final mixed methods study aimed to evaluate the development of the therapeutic relationship using Roter Interaction Analysis System to examine recorded therapy sessions. This study found patient centredness during therapy to be related to the therapeutic relationship. Exploratory analyses indentified specific features of patient-centredness that may be related to better and worse alliance. A qualitative analysis of high and low patient centred therapy sessions found that high patient centredness sessions were more likely to include general chat, encouragement, reassurance, and therapists were more responsive to participant cues. Low patient centred sessions were more likely to include participant concerns and therapists not responding to participant cues.

This thesis indentified a number of potential elements of telephone support that may be important for the development of the therapeutic relationship in patients self-managing dizziness.
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Muller, Ingrid
2569bf42-51bd-40da-bbfd-dd4dbbd62cad
Yardley, Lucy
64be42c4-511d-484d-abaa-f8813452a22e
Kirby, Sarah
9be57c1b-5ab7-4444-829e-d8e5dbe2370b

(2012) The therapeutic relationship in remote support for self management of chronic dizziness. University of Southampton, Psychology, Doctoral Thesis, 300pp.

Record type: Thesis (Doctoral)

Abstract

Telephone-delivered therapy is often used to deliver support as it can help overcome barriers that may previously have prevented patients with chronic illness from accessing key services. Very little research has looked at the therapeutic relationship during telephone support for people self-managing a chronic illness. the empirical work in this thesis is nested within a randomised controlled trial (RCT) of self-management of chronic dizziness, a condition that can be debilitating with serious consequences. This thesis explored the role of the therapeutic relationship during telephone support for using booklet-based vestibular rehabilitation (VR) to self-manage chronic dizziness.

A meta-analysis of telephone delivered therapy for chronic illness was conducted to examine whether or not telephone therapy can affect physical health outcomes. Eight RCTs (1093 patients) were included, and the results found that telephone delivered therapy significantly improved physical health outcomes in people with chronic illness (d = 0.225, 95% Cl = 0.105, 0.344). A qualitative study of people's experiences of self-managing chronic dizziness using booklet-based VR with or without telephone support (n=33) identified themes characterising people's experiences, thoughts and feelings about these models of VR delivery. Findings indicated that participants valued telephone support. Quantitative analysis examining predicators of outcome (n=112) found that the therapeutic relationship predicted change in handicap, and was related to greater enablement, although it was not related to change in dizziness symptoms. A final mixed methods study aimed to evaluate the development of the therapeutic relationship using Roter Interaction Analysis System to examine recorded therapy sessions. This study found patient centredness during therapy to be related to the therapeutic relationship. Exploratory analyses indentified specific features of patient-centredness that may be related to better and worse alliance. A qualitative analysis of high and low patient centred therapy sessions found that high patient centredness sessions were more likely to include general chat, encouragement, reassurance, and therapists were more responsive to participant cues. Low patient centred sessions were more likely to include participant concerns and therapists not responding to participant cues.

This thesis indentified a number of potential elements of telephone support that may be important for the development of the therapeutic relationship in patients self-managing dizziness.

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More information

Published date: December 2012
Organisations: University of Southampton, Psychology

Identifiers

Local EPrints ID: 358930
URI: http://eprints.soton.ac.uk/id/eprint/358930
PURE UUID: bfcf1c95-341a-4916-98c5-5f8da3f0ed4e
ORCID for Ingrid Muller: ORCID iD orcid.org/0000-0001-9341-6133
ORCID for Lucy Yardley: ORCID iD orcid.org/0000-0002-3853-883X
ORCID for Sarah Kirby: ORCID iD orcid.org/0000-0003-1759-1356

Catalogue record

Date deposited: 11 Dec 2013 16:58
Last modified: 18 Feb 2021 17:12

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