a Department of Philosophy, Sociology, Pedagogy and Applied Psychology , University of Padova , Padova , Italy.
J Psychosoc Oncol. 2014;32(5):517-34. doi: 10.1080/07347332.2014.936651.
Security of attachment is described as an inner resource that may also facilitate the adaptation of individuals during critical life adversity, even when facing end-stage illness and death. This study assessed the relation between attachment styles, patient-caregiver reciprocal empathy, and patient-physician working alliance, in the terminal phase of an oncological disease. We hypothesized that the attachment security of patients, as measured by the Relationship Questionnaire (RQ), is related to the reciprocal empathy with the caregiver, as measured by the Perception of Partner Empathy (PPE) questionnaire, and to the working alliance with the physician, as measured by the Working Alliance Inventory-Short Form (WAI-S). Thirty-seven end-stage cancer patients, their caregivers, and physicians participated in the study. The PPE and WAI-S were administered twice: immediately after the hospice recovery and a week later. Results showed a significant improvement in patient-caregiver empathy and in patient-physician alliance after a week at the hospice. Findings indicated that the patients' attachment style influenced their perception of reciprocal empathy with the caregiver and the working alliance with the physician. Patients with a secure attachment had a greater capacity to show empathic closeness with their caregivers and enjoyed a better working alliance with their physicians. Caregivers' attachment security, otherwise, did not show the same influence on empathy and alliance. Findings support the hypothesis that patients' attachment security plays a crucial role in the relation with their own caregiver and with the physician, even at the terminal phase. Theoretical and clinical implications of these findings are explored in the discussion.
依恋安全性被描述为一种内在资源，它也可以促进个体在关键生活逆境中的适应，即使是在面临终末期疾病和死亡时。本研究评估了依恋风格、患者-照顾者互惠共情以及患者-医生工作联盟在肿瘤疾病终末期的关系。我们假设，患者的依恋安全性（通过关系问卷[RQ]测量）与照顾者的互惠共情（通过伴侣共情感知问卷[PPE]测量）以及与医生的工作联盟（通过工作联盟量表-短式[WAI-S]测量）相关。37 名终末期癌症患者、他们的照顾者和医生参与了研究。PPE 和 WAI-S 分两次进行评估：在临终关怀恢复后立即和一周后。结果表明，在临终关怀一周后，患者-照顾者共情和患者-医生联盟显著改善。研究结果表明，患者的依恋风格影响他们对照顾者互惠共情的感知以及与医生的工作联盟。具有安全依恋的患者与照顾者有更强的共情亲密感，与医生的工作联盟也更好。然而，照顾者的依恋安全性并没有对共情和联盟产生同样的影响。研究结果支持了这样的假设，即患者的依恋安全性在与自己的照顾者和医生的关系中起着至关重要的作用，即使在终末期也是如此。在讨论中探讨了这些发现的理论和临床意义。
