Are patient–nurse relationships in breast cancer linked to adult attachment style?

Harding, Rachel L.; Beesley, Helen; Holcombe, Christopher; Fisher, Jean; Salmon, Peter

doi:10.1111/jan.12693

Cited by 12 publications

(13 citation statements)

References 49 publications

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“…In investigating such influences, we have drawn attention to the work that parents do to create and sustain the sort of clinical relationships that they need to feel safe. In showing that parents differ in their tendency to contain threats to their sense of relationship with clinicians, our analysis is consistent with research indicating that people vary in their ability to trust clinicians …”

Section: Discussionsupporting

confidence: 85%

“…While previous studies of problematic parent‐clinician relationships in childhood cancer have tended to rely on samples recruited from parent support groups, a strength of our study is that parents were recruited from several UK paediatric oncology centres. Few families attend support groups, so samples drawn from such groups likely provide limited insights. Moreover, by drawing on a comparison group of parents who did not perceive difficulties in clinical relationships, our analyses illuminated the processes giving rise to these perceived difficulties.…”

Section: Discussionmentioning

confidence: 99%

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When trust is threatened: Qualitative study of parents' perspectives on problematic clinical relationships in child cancer care

2017

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ObjectiveWe explored parents' accounts of the parent‐clinician relationship in childhood cancer to understand how parents who perceive threats to the relationship can be supported.MethodsMulticentre longitudinal qualitative study, with 67 UK parents of children (aged 1‐12 years) receiving treatment for acute lymphoblastic leukaemia. Analyses drew on the wider sample but focussed on 50 semistructured interviews with 20 parents and were informed by constant comparison.ResultsAll 20 parents described problems with clinical care such as inadequate information or mistakes by staff but varied in how much the problems threatened their sense of relationship with clinicians. Some parents saw the problems as having no relevance to the parent‐clinician relationship. Others saw the problems as threats to the clinical relationship but worked to “contain” the threat in ways that preserved a trusting relationship with at least one senior clinician. Parents' containment work protected the security they needed from the parent‐clinician relationship, but containment was a tenuous process for some. A few parents were unable to contain the problems at all; lacking trust in clinicians, these parents suffered considerably.ConclusionsGiven the complexity of childhood cancer care, problems with clinical care are inevitable. By engaging in containment work, parents met their needs to feel secure in the face of these problems, but the extent to which parents should have to do this work is debatable. Parents could benefit from support to seek help when problems arise which threaten their trust in clinicians. Attachment theory can guide clinicians in giving this support.

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Section: Discussionsupporting

confidence: 85%

Section: Discussionmentioning

confidence: 99%

When trust is threatened: Qualitative study of parents' perspectives on problematic clinical relationships in child cancer care

2017

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“…Of particular interest is the Interpersonal schema type, which links to theories about the role of support in adjustment (Chronister, 2009). The quality of personal relationships (and hence perception of support) is dependent on individual attachment styles (Harding, Beesley, Holcombe, Fisher & Salmon, 2015). Attachment is one of the central interpersonal theories in psychology, and attachment style has been shown to have a significant impact on selfmanagement and outcomes in diabetes (Ciechanowski et al, 2004), for instance, through the impact on the patient-provider relationship (Ciechanowski, Katon, Russo & Walker, 2001).…”

Section: Discussionmentioning

confidence: 99%

Proposal of an integrative model of adjustment to chronic conditions: An understanding of the process of psychosocial adjustment to living with type 2 diabetes

Hammond

Hirst-Winthrop

2016

J Health Psychol

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Psychosocial adjustment to living with a chronic condition was explored in this grounded theory study, focusing on type 2 diabetes. Despite a range of relevant theories, there is limited understanding of the process of adjustment. The study aimed to address this issue. That was achieved through collecting and analysing personal narratives using individual interviews and focus groups. This allowed for the development of a normative integrative model of adjustment to chronic conditions based on biopsychosocial principles. The integrative model of adjustment to chronic condition has the potential to lead to improved understanding of adjustment processes.

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“…Importantly, these aspects may be reflected in the interactions and levels of cooperation with clinical staff in a potentially stressful situation such as breast cancer treatment [ 24 , 28 ], in which the activation of the attachment motivational system may be more likely. Breast cancer patients with a positive attachment model are more likely to report receiving full support from nurses [ 27 ] and to develop an alliance with breast cancer surgeons compared to women with less positive models [ 26 ].…”

Section: Discussionmentioning

confidence: 99%

“…Breast cancer patients’ attachment model but not surgeon’s identity was modestly but significantly associated with the perceived alliance with breast cancer surgeons [ 26 ]. Similarly, in a sample of breast cancer patients attending a follow-up clinic, those with positive models of self, perceived more support from nurses [ 27 ].…”

Section: Introductionmentioning

confidence: 99%

Memories of paternal relations are associated with coping and defense mechanisms in breast cancer patients: an observational study

et al. 2017

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BackgroundBreast cancer diagnosis and treatment represent stressful events that demand emotional adjustment, thus recruiting coping strategies and defense mechanisms. As parental relations were shown to influence emotion regulation patterns and adaptive processes in adulthood, the present study investigated whether they are specifically associated to coping and defense mechanisms in patients with breast cancer.MethodsOne hundred and ten women hospitalized for breast cancer surgery were administered questionnaires assessing coping with cancer, defense mechanisms, and memories of parental bonding in childhood.ResultsHigh levels of paternal overprotection were associated with less mature defenses, withdrawal and fantasy and less adaptive coping mechanisms, such as hopelessness/helplessness. Low levels of paternal care were associated with a greater use of repression. No association was found between maternal care, overprotection, coping and defense mechanisms. Immature defenses correlated positively with less adaptive coping styles, while mature defenses were positively associated to a fighting spirit and to fatalism, and inversely related to less adaptive coping styles.ConclusionsThese data suggest that paternal relations in childhood are associated with emotional, cognitive, and behavioral regulation in adjusting to cancer immediately after surgery. Early experiences of bonding may constitute a relevant index for adaptation to cancer, indicating which patients are at risk and should be considered for psychological interventions.

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Are patient–nurse relationships in breast cancer linked to adult attachment style?

Abstract: Patients' perceptions of nurses when being treated for breast cancer are influenced by patients' own models of attachment. Knowledge of this would help nurses further to individualize the emotional support they give patients.

Cited by 12 publications

References 49 publications

When trust is threatened: Qualitative study of parents' perspectives on problematic clinical relationships in child cancer care

When trust is threatened: Qualitative study of parents' perspectives on problematic clinical relationships in child cancer care

Proposal of an integrative model of adjustment to chronic conditions: An understanding of the process of psychosocial adjustment to living with type 2 diabetes

Memories of paternal relations are associated with coping and defense mechanisms in breast cancer patients: an observational study

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