Two is a perfect number: Patient–doctor relationship and patient attachment style in palliative care

Abstract

We tested the association between the palliative patient's attachment style and the patient-doctor relationship, by means of Revised Adult Attachment Scale and a self-designed, patient-doctor relationship questionnaire. The study included 110 (52 M, 58 F) cancer, hospice patients, aged 36-80 years. We observed 54 percent of secure, 18 percent of dismissive, 9 percent of preoccupied, and 19 percent of fearful styles. Securely attached patients developed significantly ( p < .05) better relationships with doctors than insecure patients. There was no difference in the quality of the patient-doctor relationship among dismissive versus preoccupied versus fearful patients. We argue that attachment theory should be applied in palliative care to improve patients' quality of life and dying.

Working alliance and attachment orientations in the patient‐oncologist relationship

“…A similar effect was not found regarding anxious attachment orientation. These results align with those of previous studies 4,16,21,22,33 . Coping with cancer is an inherently vulnerable condition in which one must rely on others 34 .…”

“…These results align with those of previous studies. 4,16,21,22,33 Coping with cancer is an inherently vulnerable condition in which one must rely on others. 34 Avoidant individuals often distance themselves from others [10][11][12] ; they feel discomfort with vulnerability and dependence, prefer to rely on themselves, and have difficulties enjoying social support.…”

“…These patients are also often experienced by physicians as being “more difficult” than securely attached patients 17,18 . In the oncological context, insecurely attached patients have reported feeling less supported, 19 lower trust in and less satisfaction with medical caregivers, 20 along with a poorer relationship and WA with oncologists 21,22 …”

“…17,18 In the oncological context, insecurely attached patients have reported feeling less supported, 19 lower trust in and less satisfaction with medical caregivers, 20 along with a poorer relationship and WA with oncologists. 21,22 As is evident, attachment orientations mold human experience throughout life. 8 It has previously been proposed that some people with whom adults have close relationships may also provide attachment functions.…”

Pediatric cancer communication in low‐ and middle‐income countries: A scoping review

“…The reviewed studies emphasized the roles of extended family members in communication and in parallel described a diffusion of communication responsibility beyond the physician to a broader health care team. This dynamic extends past the traditional patient‐provider relationship emphasized in HICs 62‐64 and supports findings from pediatric cancer communication literature that emphasize the importance of a team approach 7,65 . The health care team is potentially even more important where human resources are limited.…”