Can patients be 'attached' to healthcare providers? An observational study to measure attachment phenomena in patient-provider relationships
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/.
OBJECTIVES: To develop and assess the validity of measures of patients' attachment-related perceptions of experiences with healthcare providers (HCPs).
SETTING: Online survey.
PARTICIPANTS: 181 people provided consent and 119 completed the survey (66%). Most participants were women (80%).
PRIMARY AND SECONDARY OUTCOME MEASURES: Questions were developed to assess possible attachment functions served by an HCP and patients' attachment-related attitudes towards an HCP. Scales were constructed based on exploratory factor analysis. Measures of adult attachment, therapeutic alliance, perceived HCP characteristics and health utilisation were used to validate scales.
RESULTS: Possible safe haven and secure base functions served by HCPs were strongly endorsed. A model with good fit (root mean square error of approximation=0.056) yielded 3 factors: 'HCP experienced as supportive and safe' (SUPPORT, α=0.94), 'HCP experienced as aversive' (AVERSE, α=0.86) and 'more and closer contact wanted with HCP' (WANT, α=0.85). SUPPORT was correlated with positive HCP characteristics and not with attachment insecurity. AVERSE was inversely correlated with positive HCP attributes and correlated with attachment insecurity. WANT was unrelated to positive HCP attributes, but correlated with attachment insecurity. Frequency of HCP contact was related to WANT (Kruskal-Wallis=21.9, p<0.001) and SUPPORT (Kruskal-Wallis=13.2, p=0.02), but not to AVERSE (Kruskal-Wallis=1.7, p=0.89).
CONCLUSIONS: Patients attribute attachment functions of secure base and safe haven to HCPs. SUPPORT is related to positive appraisal of HCP characteristics; AVERSE is associated with discomfort in the HCP relationship that is related with perceived HCP characteristics and patients' insecure attachment; WANT is associated with unmet needs for connection with an HCP related to insecure attachment, but not to perceived HCP characteristics. These scales may be useful in studying the application of attachment theory to the HCP-patient relationship.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2016 |
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| Erschienen: |
2016 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:6 |
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| Enthalten in: |
BMJ open - 6(2016), 5 vom: 13. Mai, Seite e011068 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Maunder, Robert G [VerfasserIn] |
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| Links: |
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| Themen: |
Attachment |
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| Anmerkungen: |
Date Completed 06.12.2017 Date Revised 02.02.2019 published: Electronic Citation Status MEDLINE |
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| doi: |
10.1136/bmjopen-2016-011068 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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NLM26034477X |
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| 245 | 1 | 0 | |a Can patients be 'attached' to healthcare providers? An observational study to measure attachment phenomena in patient-provider relationships |
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| 500 | |a Date Revised 02.02.2019 | ||
| 500 | |a published: Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ | ||
| 520 | |a OBJECTIVES: To develop and assess the validity of measures of patients' attachment-related perceptions of experiences with healthcare providers (HCPs) | ||
| 520 | |a SETTING: Online survey | ||
| 520 | |a PARTICIPANTS: 181 people provided consent and 119 completed the survey (66%). Most participants were women (80%) | ||
| 520 | |a PRIMARY AND SECONDARY OUTCOME MEASURES: Questions were developed to assess possible attachment functions served by an HCP and patients' attachment-related attitudes towards an HCP. Scales were constructed based on exploratory factor analysis. Measures of adult attachment, therapeutic alliance, perceived HCP characteristics and health utilisation were used to validate scales | ||
| 520 | |a RESULTS: Possible safe haven and secure base functions served by HCPs were strongly endorsed. A model with good fit (root mean square error of approximation=0.056) yielded 3 factors: 'HCP experienced as supportive and safe' (SUPPORT, α=0.94), 'HCP experienced as aversive' (AVERSE, α=0.86) and 'more and closer contact wanted with HCP' (WANT, α=0.85). SUPPORT was correlated with positive HCP characteristics and not with attachment insecurity. AVERSE was inversely correlated with positive HCP attributes and correlated with attachment insecurity. WANT was unrelated to positive HCP attributes, but correlated with attachment insecurity. Frequency of HCP contact was related to WANT (Kruskal-Wallis=21.9, p<0.001) and SUPPORT (Kruskal-Wallis=13.2, p=0.02), but not to AVERSE (Kruskal-Wallis=1.7, p=0.89) | ||
| 520 | |a CONCLUSIONS: Patients attribute attachment functions of secure base and safe haven to HCPs. SUPPORT is related to positive appraisal of HCP characteristics; AVERSE is associated with discomfort in the HCP relationship that is related with perceived HCP characteristics and patients' insecure attachment; WANT is associated with unmet needs for connection with an HCP related to insecure attachment, but not to perceived HCP characteristics. These scales may be useful in studying the application of attachment theory to the HCP-patient relationship | ||
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| 650 | 4 | |a provider-patient relationship | |
| 650 | 4 | |a therapeutic alliance | |
| 700 | 1 | |a Hunter, Jonathan J |e verfasserin |4 aut | |
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