Patients’ perspectives on physiotherapist’s empathy and its association with therapeutic alliance: a cross-sectional study

Abstract

Background: Empathy and therapeutic alliance play a central role in patient-centered physiotherapy and contribute to better treatment outcomes. However, evidence on the relationship between them remains limited, particularly in Pakistan. Therefore, this study aimed to examine the relationship between empathy and therapeutic alliance among patients receiving physiotherapy.

Material and methods: Convenience sampling was used to identify 373 participants for this cross-sectional study, which took place in the Physical Therapy Department of Rehman Medical Institute between June and November of 2024. The 10-item CARE questionnaire was used to measure empathy with a Cronbach’s alpha value of 0.95, while the 12-item Working Alliance Inventory–Short Revised (Cronbach’s alpha = 0.85) was used to measure therapeutic alliance. IBM SPSS Statistics v22 was used to analyze the data.

Results: Of the 373 participants, the majority were female (53.4%) and fell within the 31–40 age range (28.2%). 40.2% of patients had chronic diseases, whereas 79.1% of patients were receiving treatment for musculoskeletal disorders. The findings showed that a better therapeutic alliance between patients and therapists was substantially correlated with higher empathy levels. Pearson's r = 0.506, 95% CI [0.42, 0.58].

Conclusion: Higher therapist empathy is associated with a better patient-therapist interaction, as evidenced by a moderate positive correlation between empathy and TA. This implies that more effective, person-centered physiotherapy care can be supported by empathic communication, which can also increase trust and patient participation.