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

Adult Age Factors Anxiety / psychology Attitude to Health Communication Defense Mechanisms Female Health Personnel Humans Leukemia / psychology Male Middle Aged Object Attachment Professional-Patient Relations
acute leukemia age attachment security cancer communication hematology oncology young adults

Journal

Psycho-oncology
ISSN: 1099-1611
Titre abrégé: Psychooncology
Pays: England
ID NLM: 9214524

Informations de publication

Date de publication:
01 2019
Historique:
received: 23 03 2018
revised: 08 09 2018
accepted: 19 09 2018
pubmed: 13 10 2018
medline: 24 12 2019
entrez: 13 10 2018
Statut: ppublish

Résumé

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). 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. 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. 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.

Sections du résumé

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.

Identifiants

DOI: 10.1002/pon.4919 PMID: 30312520
pubmed: 30312520
doi: 10.1002/pon.4919
doi:

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

122-130

Subventions

Organisme : CIHR
ID : CIHR MOP-84317
Pays : Canada

Informations de copyright

© 2018 John Wiley & Sons, Ltd.

Auteurs

Brooke Fraser (B)

Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Chana Korenblum (C)

Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Division of Adolescent Medicine, Department of Pediatrics, Hospital for Sick Children, Toronto, Ontario, Canada.

Kenneth Mah (K)

Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Sarah Watt (S)

Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Carmine Malfitano (C)

Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Anne Rydall (A)

Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.

Aaron Schimmer (A)

Department of Medical Oncology and Hematology, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Department of Medical Biophysics, University of Toronto, Toronto, Ontario, Canada.

Camilla Zimmermann (C)

Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Department of Medicine, University of Toronto, Toronto, Ontario, Canada.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.

Gary Rodin (G)

Department of Supportive Care, Princess Margaret Cancer Centre, University Health Network, Toronto, Ontario, Canada.
Department of Psychiatry, University of Toronto, Toronto, Ontario, Canada.
ORCID: 0000-0002-6626-6974

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Classifications MeSH

questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › The experience of medical communication in...
questionsmedicales.fr › Environnement et santé publique › Santé publique › Facteurs épidémiologiques › Facteurs âges › The experience of medical communication in...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Émotions › Anxiété › The experience of medical communication in...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Attitude envers la santé › The experience of medical communication in...
questionsmedicales.fr › Sciences de l'information › Communication › The experience of medical communication in...
questionsmedicales.fr › Comportement et mécanismes comportementaux › Mécanismes de défense › The experience of medical communication in...
questionsmedicales.fr › Établissements, main d'oeuvre et services de soins de santé › Personnel de santé › The experience of medical communication in...
questionsmedicales.fr › Eucaryotes › Animaux › Chordés › Vertébrés › Mammifères › Eutheria › Primates › Haplorhini › Catarrhini › Hominidae › Humains › The experience of medical communication in...
questionsmedicales.fr › Tumeurs › Tumeurs par type histologique › Leucémies › The experience of medical communication in...
questionsmedicales.fr › Personnes › Tranches d'âge › Adulte › Adulte d'âge moyen › The experience of medical communication in...
questionsmedicales.fr › Phénomènes psychologiques › Théorie psychologique › Théorie psychanalytique › Attachement à l'objet › The experience of medical communication in...
questionsmedicales.fr › Qualité, accès, évaluation des soins de santé › Prestations des soins de santé › Relations entre professionnels de santé et patients › The experience of medical communication in...