title: Do patients trust their physician? The role of attachment style in the patient-physician relationship within one year after a cancer diagnosis.
abstract: BACKGROUND
  The degree of trust in and satisfaction with the physician has been shown to have important implications for treatment outcomes. This study aims to examine individual differences in patients' trust, satisfaction and general distress from an attachment theoretical perspective.
  
  
  METHODS
  One hundred and thirty recently diagnosed cancer patients of three medical hospitals were extensively interviewed by trained psychologists to assess attachment style. Patients completed standardized questionnaires three and nine months after diagnosis to assess trust, satisfaction and distress. t-tests and repeated measures ANOVAs were used to examine differences between securely and insecurely attached patients and changes over time. A mediation model based on a bootstrapping method was used to examine whether trust mediated between attachment and satisfaction, and attachment and distress.
  
  
  RESULTS
  Insecurely attached patients (N = 45, 35%) reported less trust in and satisfaction with their physician, and reported more general distress than securely attached patients three and nine months after diagnosis (p < 0.05). Trust and distress levels did not change over time. Trust mediated between attachment and satisfaction, but not between attachment and distress.
  
  
  CONCLUSIONS
  Insecurely attached patients trusted their physician less than securely attached patients, and in turn were less satisfied with their physician. Their higher levels of general distress were not related to their lower levels of trust. Attachment theory provides a framework to interpret differences in patients' trust, satisfaction and distress, and may help physicians respond in such a way that their patients feel secure, which in turn is expected to result in better health outcomes.
authors.affiliation: Department of Health Sciences, Health Psychology Section, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands. n.holwerda@umcg.nl
authors.forename: Nynke
authors.initials: N
authors.lastname: Holwerda
authors.forename: Robbert
authors.initials: R
authors.lastname: Sanderman
authors.forename: Grieteke
authors.initials: G
authors.lastname: Pool
authors.forename: Chris
authors.initials: C
authors.lastname: Hinnen
authors.forename: Johannes A
authors.initials: JA
authors.lastname: Langendijk
authors.forename: Willem A
authors.initials: WA
authors.lastname: Bemelman
authors.forename: Mariët
authors.initials: M
authors.lastname: Hagedoorn
authors.forename: Mirjam A G
authors.initials: MA
authors.lastname: Sprangers
mesh_terms: D000704:Analysis of Variance; D015897:Comorbidity; D005260:Female; D006304:Health Status; D006801:Humans; D007406:Interview, Psychological; D008297:Male; D008875:Middle Aged; D009369:Neoplasms / Q000175:diagnosis / Q000453:epidemiology / Q000523:psychology*; D009426:Netherlands / Q000453:epidemiology; D009769:Object Attachment; D017060:Patient Satisfaction; D010817:Physician-Patient Relations; D013315:Stress, Psychological / Q000523:psychology; D011795:Surveys and Questionnaires; D035502:Trust