Munoz Ricky T, Hanks Heather, Brahm Nancy C, Miller Christina R, McLeod David, Fox Mark D
J Health Care Poor Underserved. 2019;30(1):238-248. doi: 10.1353/hpu.2019.0018.
Attachment theory suggests that adverse childhood experiences (ACEs) should predict lower trust in the medical profession. To test this theory, a cross-sectional survey was administered to young adults self-identifying as homeless. The purpose of the survey was to examine the relationship of ACEs, attachment style, and trust in the medical profession. Hierarchical linear regression was used to determine if ACEs predict variance in trust in the medical profession after controlling for participants' attachment style and demographics. Results indicated ACEs were a robust predictor of lower trust in the medical profession over the controls. Since lower trust in the medical profession is associated with less willingness to seek care and follow provider recommendations, the established link between poorer health and ACEs may partially result from lower trust in the medical profession. The paper concludes with a discussion of the results' implications for future research and practice with ACE survivors.
依恋理论表明，童年不良经历（ACEs）应该预示着对医疗行业的信任度较低。为了验证这一理论，对自我认定为无家可归的年轻人进行了一项横断面调查。该调查的目的是检验ACEs、依恋风格与对医疗行业的信任之间的关系。在控制了参与者的依恋风格和人口统计学特征后，使用分层线性回归来确定ACEs是否能预测对医疗行业信任度的差异。结果表明，与对照组相比，ACEs是对医疗行业信任度较低的一个有力预测因素。由于对医疗行业的信任度较低与寻求医疗护理和遵循医疗服务提供者建议的意愿较低有关，健康状况较差与ACEs之间已确立的联系可能部分是由于对医疗行业的信任度较低所致。本文最后讨论了研究结果对未来针对ACE幸存者的研究和实践的启示。
