The Kim Alliance Scale: development and preliminary testing

The development and preliminary testing of the Kim Alliance Scale (KAS) is described. The KAS was developed to measure the quality of the therapeutic alliance from the patient's perspective, including patient empowerment. By triangulating literature findings and qualitative data, a conceptual framework was derived with four dimensions of alliance: collaboration, communication, integration, and empowerment. Using the 48-item KAS, 68 nurses evaluated their alliance (as patients) with their own health care providers. Standard psychometric procedures were used to test for reliability and validity. The KAS was reduced to 30 items having an internal consistency reliability coefficient alpha of .94 and split-half alphas of .87 and .91. Initial support was found for convergent and divergent validity. The KAS may be a useful tool for measuring therapeutic alliance, identifying the foci for interventions to improve the alliance, and improving treatment outcomes.