Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
Department of Medical Psychology, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
J Pain Symptom Manage. 2017 Oct;54(4):555-562. doi: 10.1016/j.jpainsymman.2017.07.026. Epub 2017 Jul 15.
Attachment insecurity refers to difficulty in trusting and relying on others in times of need. Its underlying factors attachment anxiety and attachment avoidance have been empirically associated with impaired coping in advanced cancer and, therefore, should be considered in individually tailored medical and psychosocial treatment.
The objective of this study was to evaluate the psychometric properties of the German translation of the Brief Experiences in Close Relationships Scale (ECR-M16-G).
We recruited 182 advanced cancer patients from outpatient psycho-oncology clinics of the University Medical Center Hamburg-Eppendorf and the University Medical Center Leipzig, local and external cancer care facilities. We performed confirmatory factor analysis to replicate the higher order factor structure reported in previous research. We conducted item and reliability analysis, also correlation analysis, to examine concurrent validity.
One hundred fifty-eight patients completed the ECR-M16-G (women 61%, mean age 57.9, SD = 11.1). We replicated the factor structure with the subscales Attachment Anxiety and Attachment Avoidance as second-order factors and Worrying about relationships, Frustration about unavailability, Discomfort with close others, and Turning away from others as first-order factors. An adjusted model that interchanged factor loadings of items 4 and 10 showed good fit (Comparative Fit Index = 0.94, Non-Normed Fit Index = 0.93, root mean square error of approximation = 0.05). Subscales showed acceptable to good internal consistency (anxiety α = .81 and avoidance α = .78). Attachment insecurity (mean = 3.1, SD = 1.0) was positively associated with depression, anxiety, demoralization (P < 0.001), and symptom burden (P = 0.02) and negatively associated with spiritual well-being (P < 0.001).
The ECR-M16-G is a valid and reliable measure of attachment insecurity in patients with advanced cancer and can be recommended as a tool for clinical care and further research.
依附不安全感是指在需要时难以信任和依赖他人。其潜在因素——依附焦虑和依附回避——已被实证研究与晚期癌症患者应对能力受损相关，因此，在制定个体化的医疗和心理社会治疗方案时应考虑到这一点。
本研究旨在评估《亲密关系经历量表简表》（ECR-M16-G）德文版的心理测量学特性。
我们从汉堡-埃彭多夫大学医学中心和莱比锡大学医学中心的门诊心理肿瘤学诊所、当地和外部癌症护理机构招募了 182 名晚期癌症患者。我们进行了验证性因子分析，以复制先前研究报告的高阶因子结构。我们进行了项目和信度分析，以及相关分析，以检验同时效度。
158 名患者完成了 ECR-M16-G（女性 61%，平均年龄 57.9，标准差=11.1）。我们复制了二阶因子结构，包含依附焦虑和依附回避两个子量表，以及关系担忧、可得性挫折、与亲近者的不适和回避亲近者等一阶因子。一个交换项目 4 和 10 的因子负荷的调整模型显示出良好的拟合度（比较拟合指数=0.94，非标准拟合指数=0.93，近似均方根误差=0.05）。子量表表现出可接受至良好的内部一致性（焦虑α=0.81，回避α=0.78）。依附不安全感（均值=3.1，标准差=1.0）与抑郁、焦虑、沮丧（P<0.001）和症状负担（P=0.02）呈正相关，与精神健康呈负相关（P<0.001）。
ECR-M16-G 是一种有效的、可靠的晚期癌症患者依附不安全感的测量工具，可作为临床护理和进一步研究的工具推荐。
