Department of Medical Psychology and Hospital Psychiatry, Slotervaart Hospital, Amsterdam, The Netherlands; Section Health Psychology, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Section Health Psychology, Department of Health Sciences, University Medical Centre Groningen, University of Groningen, Groningen, The Netherlands.
Gen Hosp Psychiatry. 2014 Jul-Aug;36(4):382-7. doi: 10.1016/j.genhosppsych.2014.03.005. Epub 2014 Mar 12.
In the present study, we investigated individual differences in the outcome of patient-physician trust when confronted with cancer from an attachment theoretical perspective. We expected that lower levels of trust are associated with more emotional distress and more physical limitations within the first 15 months after diagnosis, especially in those who score relatively high on attachment anxiety. No such association was expected for more avoidantly attached individuals.
A group of 119 patients with different types of cancer (breast, cervical, intestinal and prostate) completed questionnaires concerning trust (short version of the Wake Forest Physician Trust Scale) and attachment (Experiences in Close Relationship scale Revised) at 3 months after diagnosis. Emotional distress (Hospital Anxiety and Depression Scale) and physical limitations (physical functioning subscales of the European Organization for Research and Treatment of Cancer, Quality of Life Questionnaire-C30) were assessed at 3, 9 and 15 months after diagnosis. To test the hypotheses, multiple hierarchical regression analyses were performed.
Lower levels of trust were associated with more emotional distress and more physical limitations at 3, 9 and 15 months after diagnosis in more anxiously attached patients, but not in less anxiously attached patients.
These results indicate an attachment-dependent effect of trust in one's physician. Explanations and clinical implications are discussed.
本研究从依恋理论的角度探讨了面对癌症时患者-医生信任的个体差异对结果的影响。我们预计，在诊断后最初的 15 个月内，较低水平的信任与更多的情绪困扰和更多的身体限制相关，特别是在那些依恋焦虑得分相对较高的人群中。对于回避依恋程度较高的人群，则没有这种关联。
一组患有不同类型癌症（乳腺癌、宫颈癌、肠癌和前列腺癌）的 119 名患者在诊断后 3 个月时完成了信任（威克森林医生信任量表的简短版本）和依恋（亲密关系经验量表修订版）的问卷。在诊断后 3、9 和 15 个月时评估了情绪困扰（医院焦虑和抑郁量表）和身体限制（欧洲癌症研究和治疗组织生活质量问卷-C30 的身体功能子量表）。为了验证假设，进行了多次分层回归分析。
在更焦虑依恋的患者中，较低水平的信任与诊断后 3、9 和 15 个月时更多的情绪困扰和身体限制相关，而在焦虑依恋程度较低的患者中则没有这种相关性。
这些结果表明，患者对医生的信任存在一种依赖于依恋的效应。解释和临床意义也进行了讨论。
