Chapter 2 24 therapy, and insufficient mastery of the Dutch language to complete the questionnaires. Routing The researcher invited patients potentially meeting the inclusion criteria to participate in this study. The researcher provided the patients further information and checked if the patients met the inclusion criteria. Patients who met the criteria and agreed to participate signed an informed consent form and were included in the study, taking into account that half of the patients had musculoskeletal complaints and the other half had chronic diseases. Identifying and including patients continued till the sample size, needed for this study, was reached. In the same period, participating physiotherapists (raters) were invited to participate in this study and were told that the study used informed consent. Baseline variables Participants’ age (year), gender (male/ female), previous history of physiotherapy treatments (yes/no), and physiotherapeutic diagnosis (musculoskeletal injury or chronic disease) were recorded. Study procedure Before measurement, the researcher explained the meaning of adherence and the use of the RAdMAT-NL to the raters. The RAdMAT-NL is a 16-item questionnaire that uses a four-point rating scale and asks about patient clinic-based adherence that includes the patients’ attitudes and communication along with their clinic behaviors [13]. The raters were asked to assess the adherence of the patients independently. First the physiotherapists assessed adherence of three patients as a group. Based on this exercise, consensus was obtained regarding the use of this measurement instrument. Then two physiotherapists were randomly matched (based on there working days) to both assess the adherence of a patient when measurement started. The following characteristics of the physiotherapist were recorded: gender (male/female), completed Master’s degree (yes/no), and professional experience in a primary physiotherapy practice (years). Between November 1 and December 1, 2017, the physiotherapists independently assessed the adherence of a patient at the end of the treatment. Participants were aware that they participated in the study and that they were assessed between November 1 and December 1, but they did not know when the assessment took place. In this way, the participant was blinded for the assessment and could not meet with the rater (preventing information bias). Both physiotherapists independently assessed the patients so, their assessments were not influenced by each other; both raters were blinded for each other’s results. During the study, it
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