在姑息治疗中预防延长哀伤障碍:不安全依恋调节感知支持对症状严重程度的影响。
Toward a preventive approach to prolonged grief disorder in palliative care: Insecure attachment moderates the impact of perceived support on the severity of symptoms.
机构信息
Department Educational Sciences, University of Catania, Catania, Italy.
Department of Clinical and Experimental Medicine, University of Messina, Messina, Italy.
出版信息
PLoS One. 2022 Dec 1;17(12):e0266289. doi: 10.1371/journal.pone.0266289. eCollection 2022.
OBJECTIVE
This study aimed to investigate the relationships between perceived support at the time of assistance, insecure attachment (i.e., avoidance and anxious attachment), and prolonged grief symptoms in family caregivers of palliative care patients deceased for at least one year. We also investigated the moderating role of insecure attachment in the relationship between perceived support and the intensity of prolonged grief symptoms.
METHOD
An exploratory cross-sectional design was used. A sample of 157 participants completed the Prolonged Grief Scale (PG-13) and the Attachment Style Questionnaire (ASQ).
RESULTS
Correlational analyses indicated that prolonged grief symptoms were positively correlated with Avoidance attachment but not with Anxious attachment. Perceived support was negatively correlated with both the Avoidance and Anxious attachment factors. Lastly, the two insecure attachment dimensions were moderately and positively correlated with each other. Results of moderation analysis showed that high Avoidance attachment moderated the effect of perceived family and social support on the intensity of prolonged grief symptoms among family caregivers of palliative home-care-assisted patients. Results also showed that the Anxious attachment factor had a significant effect on prolonged grief symptoms, even though the interaction with perceived support was not significant.
CONCLUSIONS
Overall, these results underline that a high level of avoidance attachment may moderate the relationship between perceived support and the intensity of grief symptoms, thereby increasing the risk of developing a mental disorder. Interventions to prevent prolonged grief disorder among family caregivers should take these findings into account.
目的
本研究旨在探讨在姑息治疗患者死亡至少一年的家庭照顾者中,援助时的感知支持、不安全依恋(即回避和焦虑依恋)与延长哀伤症状之间的关系。我们还研究了不安全依恋在感知支持与延长哀伤症状强度之间关系中的调节作用。
方法
采用探索性横截面设计。157 名参与者完成了延长哀伤量表(PG-13)和依恋风格问卷(ASQ)。
结果
相关分析表明,延长哀伤症状与回避依恋呈正相关,与焦虑依恋无关。感知支持与回避和焦虑依恋两个因素均呈负相关。最后,两个不安全依恋维度中度且正相关。调节分析结果表明,高回避依恋调节了家庭和社会支持感知对姑息治疗家庭照顾者延长哀伤症状强度的影响。结果还表明,焦虑依恋因素对延长哀伤症状有显著影响,尽管与感知支持的相互作用不显著。
结论
总体而言,这些结果强调了高水平的回避依恋可能会调节感知支持与哀伤症状强度之间的关系,从而增加出现精神障碍的风险。预防姑息治疗家庭照顾者中延长哀伤障碍的干预措施应考虑到这些发现。