title: Are patient-nurse relationships in breast cancer linked to adult attachment style?
abstract: OBJECTIVE
  The aim of this study was to ascertain if patients with breast cancer who have positive attachment models of 'self' and 'other' perceive higher levels of support from nurses than do patients with negative attachment models.
  
  
  BACKGROUND
  Attachment models of 'self' and 'other' develop in childhood and affect relationships throughout life. People with negative attachment models tend to perceive themselves as unworthy of receiving support and to perceive others as incapable or unwilling to offer support. Attachment processes are activated when individuals feel threatened and seek support from those close to them. Breast cancer may represent such a threat and relationships between patients with breast cancer and nurses may therefore be influenced by patients' attachment models.
  
  
  METHODS
  A between-subjects cross-sectional design was used. Explanatory variables were indicators of patients' attachment models. Response variables were patient ratings of nurse support. Covariates were patient age and patient distress levels.
  
  
  METHODS
  One hundred and fifty-three patients with breast cancer, diagnosed 1-3 years previously, were recruited when attending follow-up oncology appointments over 51 weeks in 2010-2011. Participants completed questionnaires assessing attachment models, distress and perceived support, from the nurse who was available to support them through their cancer. The hypotheses were tested by logistic regression analysis.
  
  
  RESULTS
  Patients with more positive models of 'self' perceived more support from nurses.
  
  
  CONCLUSIONS
  Patients' perceptions of nurses when being treated for breast cancer are influenced by patients' own models of attachment. Knowledge of this would help nurses further to individualize the emotional support they give patients.
authors.affiliation: Barts Health NHS Trust, Liverpool, UK.
authors.forename: Rachel
authors.initials: R
authors.lastname: Harding
authors.affiliation: Royal Liverpool and Broadgreen University Hospitals NHS Trust, UK.
authors.forename: Helen
authors.initials: H
authors.lastname: Beesley
authors.affiliation: Royal Liverpool and Broadgreen University Hospitals NHS Trust, UK.
authors.forename: Christopher
authors.initials: C
authors.lastname: Holcombe
authors.affiliation: Royal Liverpool and Broadgreen University Hospitals NHS Trust, UK.
authors.forename: Jean
authors.initials: J
authors.lastname: Fisher
authors.affiliation: University of Liverpool, UK.
authors.forename: Peter
authors.initials: P
authors.lastname: Salmon
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001943:Breast Neoplasms / Q000451:nursing / Q000523:psychology*; D003142:Communication; D003430:Cross-Sectional Studies; D005260:Female; D006801:Humans; D008875:Middle Aged; D009723:Nurse-Patient Relations; D009769:Object Attachment; D017060:Patient Satisfaction; D010465:Perception
keywords: breast cancer; interpersonal communication; nurse-patient relationship; nursing; psychology