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The experience of medical communication in adults with acute leukemia: Impact of age and attachment security.

Abstract：

BACKGROUND:Health care providers' (HCPs) communication with cancer patients provides both information and support. Younger patient age and greater difficulty accepting support (attachment security) have been linked to poorer communication experiences with HCPs. The present secondary data analysis examined the impact of age group and attachment security on perceived communication problems with HCPs in adults with acute leukemia (AL). METHODS:The sample included 95 younger (age < 40 years) and 225 older (age ≥ 40 years) patients with newly diagnosed or recently relapsed AL. We assessed avoidant and anxious attachment security (reluctance to accept support and fear of its unavailability, respectively) with the modified 16-item Experiences in Close Relationships Scale. The impact of age group and attachment security on perceived communication problems, measured with the Cancer Rehabilitation Evaluation System-Medical Interaction Subscale, was assessed based on the presence and extent of communication problems. RESULTS:Younger patients (OR = 1.79-1.82, P = .030) and those with greater avoidant (OR = 1.44, P = .001) or anxious attachment (OR = 1.38, P = .009) were more likely to report communication problems. A similar relationship was found between age (β's = -.17-.19, P = .015-.025), avoidant (β = .29, P = .013), or anxious attachment (β = .17, P = .031), and the extent of communication problems. A significant age-group × avoidant-attachment interaction (β = -.31, P = .008) suggested that more avoidant attachment was associated with more perceived communication problems in the younger but not in the older group. CONCLUSIONS:Younger patients with AL, especially those more reluctant to seek or accept support, perceive more communication problems with their HCPs than older patients. Greater attention by HCPs to their communication with younger patients is needed.

journal_name

Psychooncology

journal_title

Psycho-oncology

authors

Fraser B,Korenblum C,Mah K,Watt S,Malfitano C,Rydall A,Schimmer A,Zimmermann C,Rodin G

doi

10.1002/pon.4919

subject

Has Abstract

pub_date

2019-01-01 00:00:00

pages

122-130

issue

eissn

1057-9249

issn

1099-1611

journal_volume

pub_type

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The experience of medical communication in adults with acute leukemia: Impact of age and attachment security.