A dyadic examination of patients' and caregivers' attachment orientations and mutually supportive care in cancer caregiving.

Abstract

Families play a pivotal role in supporting one another during cancer. Research suggests that supportive care interactions between patients and their caregivers can have a positive effect on the physical health and well-being of both members of the dyad. However, few studies have investigated how patient and caregiver personality characteristics intersect with their perceptions of supportive exchanges. Adopting an attachment theory perspective, our aim was to examine the dyadic effects of patient and caregiver attachment orientations on mutually supportive care. Patients (n=103) receiving cancer care and their caregivers (n=99) completed a survey that comprised measures of attachment orientations (Experiences in Close Relationships Modified scale), and mutually supportive care (Shared Care Inventory, SCI-3): communication, decision-making and reciprocity. Actor-Partner Interdependence Models (APIMs) were used to examine the association between participants' attachment orientations on their own (actor effects) SCI-3 outcomes and those of the other person within the dyad (partner effects). Across the APIMs, the tendency was for an inverse relationship between attachment (anxious and avoidant orientations) and mutually supportive care. Inspection of the effects and dyadic patterns supported actor and couple models. Using a dyadic approach, it was possible to study both intrapersonal and interpersonal effects. Our findings point to interdependence within the cancer caregiving relationship and underscore the importance of considering how individual and relational ways of responding influence support. Attachment theory provides a framework for explaining the observed relationships and a basis for therapeutic intervention.