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Can patients be ‘attached’ to healthcare providers? An observational study to measure attachment phenomena in patient–provider relationships
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%). PRIMA...
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BMJ Publishing Group
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874120/ https://www.ncbi.nlm.nih.gov/pubmed/27178976 http://dx.doi.org/10.1136/bmjopen-2016-011068 |
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author | Maunder, Robert G Hunter, Jonathan J |
author_facet | Maunder, Robert G Hunter, Jonathan J |
author_sort | Maunder, Robert G |
collection | PubMed |
description | 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. |
format | Online Article Text |
id | pubmed-4874120 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | BMJ Publishing Group |
record_format | MEDLINE/PubMed |
spelling | pubmed-48741202016-05-27 Can patients be ‘attached’ to healthcare providers? An observational study to measure attachment phenomena in patient–provider relationships Maunder, Robert G Hunter, Jonathan J BMJ Open Patient-Centred Medicine 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. BMJ Publishing Group 2016-05-13 /pmc/articles/PMC4874120/ /pubmed/27178976 http://dx.doi.org/10.1136/bmjopen-2016-011068 Text en 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/ This is an Open Access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ |
spellingShingle | Patient-Centred Medicine Maunder, Robert G Hunter, Jonathan J Can patients be ‘attached’ to healthcare providers? An observational study to measure attachment phenomena in patient–provider relationships |
title | Can patients be ‘attached’ to healthcare providers? An observational study to measure attachment phenomena in patient–provider relationships |
title_full | Can patients be ‘attached’ to healthcare providers? An observational study to measure attachment phenomena in patient–provider relationships |
title_fullStr | Can patients be ‘attached’ to healthcare providers? An observational study to measure attachment phenomena in patient–provider relationships |
title_full_unstemmed | Can patients be ‘attached’ to healthcare providers? An observational study to measure attachment phenomena in patient–provider relationships |
title_short | Can patients be ‘attached’ to healthcare providers? An observational study to measure attachment phenomena in patient–provider relationships |
title_sort | can patients be ‘attached’ to healthcare providers? an observational study to measure attachment phenomena in patient–provider relationships |
topic | Patient-Centred Medicine |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4874120/ https://www.ncbi.nlm.nih.gov/pubmed/27178976 http://dx.doi.org/10.1136/bmjopen-2016-011068 |
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