Attachment figures when death is approaching: a study applying attachment theory to adult patients' and family members' experiences during palliative home care
- PMID: 28220315
- PMCID: PMC5445221
- DOI: 10.1007/s00520-017-3634-7
Attachment figures when death is approaching: a study applying attachment theory to adult patients' and family members' experiences during palliative home care
Abstract
Purpose: Attachment theory is currently receiving much attention in relation to how adults cope with severe illness. The study aims were using the experiences of patients and family members to explore attachment figures (a central concept within the theory) during palliative home care.
Methods: Twelve patients and 14 family members were interviewed during ongoing palliative home care. The interviews were analysed using qualitative content analysis.
Results: Four types of attachment figures were identified: (i) family and friends, (ii) health care practitioners, (iii) pets and (iv) God. Both non-physical and physical contact with the attachment figures facilitated a sense of security. In addition, the patient/family members and their attachment figures were described by some as a "we", and when one part of the "we" felt insecure, this made the other also feel insecure. The patients' unstable and progressing illnesses constituted a threat to the patients' and family members' sense of security. The availability of the attachment figures made them feel secure, and they could then divert their attention from the patients' illnesses to other things in everyday life, e.g. socialising with family and friends. Some family members also had to cope with the loss of their own attachment figure, when the patient, who had previously been a source of security for them, was no longer able to offer protection and comfort due to the progression of the illness.
Conclusion: Important aspects of attachment figures in the end-of-life context were identified, and their clinical implications will be discussed.
Keywords: Attachment figure; Attachment theory; Family member; Palliative; Patient.
Conflict of interest statement
The authors declare that they have no conflict of interest.
Figures
Similar articles
-
What is a 'secure base' when death is approaching? A study applying attachment theory to adult patients' and family members' experiences of palliative home care.Psychooncology. 2012 Aug;21(8):886-95. doi: 10.1002/pon.1982. Epub 2011 May 6. Psychooncology. 2012. PMID: 21557383
-
Patients' sense of security during palliative care-what are the influencing factors?J Pain Symptom Manage. 2014 Jul;48(1):45-55. doi: 10.1016/j.jpainsymman.2013.08.021. Epub 2014 May 5. J Pain Symptom Manage. 2014. PMID: 24801659
-
Can a single question about family members' sense of security during palliative care predict their well-being during bereavement? A longitudinal study during ongoing care and one year after the patient's death.BMC Palliat Care. 2019 Jul 25;18(1):63. doi: 10.1186/s12904-019-0446-1. BMC Palliat Care. 2019. PMID: 31345200 Free PMC article.
-
[Home care services and the role of "caregivers"].Minerva Pediatr. 2001 Jun;53(3):161-9. Minerva Pediatr. 2001. PMID: 11455302 Review. Italian.
-
Security-enhancement Processes within Group Settings: Revising Insecure Working Models of Attachment During Playful Group Interactions.Int J Group Psychother. 2024 Apr;74(2):98-121. doi: 10.1080/00207284.2024.2314758. Epub 2024 Mar 4. Int J Group Psychother. 2024. PMID: 38437036 Review.
Cited by
-
Attachment: the mediating role of hope, religiosity, and life satisfaction in older adults.Health Qual Life Outcomes. 2021 Feb 15;19(1):57. doi: 10.1186/s12955-021-01695-y. Health Qual Life Outcomes. 2021. PMID: 33588858 Free PMC article.
-
A Personalised Caring Approach at Home-Patients, Relatives and Nurses' Experiences of Specialised Palliative Care: An Integrative Literature Review.Nurs Open. 2025 Feb;12(2):e70155. doi: 10.1002/nop2.70155. Nurs Open. 2025. PMID: 39887669 Free PMC article. Review.
-
Attachment as a mechanism influencing end-of-life communication: An analogue investigation.PLoS One. 2024 Jul 31;19(7):e0303652. doi: 10.1371/journal.pone.0303652. eCollection 2024. PLoS One. 2024. PMID: 39083512 Free PMC article.
-
Current Advances in Palliative & Hospice Care: Problems and Needs of Relatives and Family Caregivers During Palliative and Hospice Care-An Overview of Current Literature.Med Sci (Basel). 2019 Mar 12;7(3):43. doi: 10.3390/medsci7030043. Med Sci (Basel). 2019. PMID: 30871105 Free PMC article. Review.
-
(Don't) Leave Me Alone: Attachment in Palliative Care.J Palliat Med. 2022 Jan;25(1):9-14. doi: 10.1089/jpm.2021.0491. J Palliat Med. 2022. PMID: 34978911 Free PMC article.
References
-
- Bowlby J (1997, c 1969) Attachment and loss. Volume 1. Attachment, 2nd edn. Pimlico; London
-
- Mikulincer M, Shaver PR. Attachment in adulthood: structure, dynamics, and change. New York: Guildford Press; 2007.
-
- Milberg A, Wahlberg R, Jakobsson M, Olsson EC, Olsson M, Friedrichsen M. What is a 'secure base' when death is approaching? A study applying attachment theory to adult patients' and family members' experiences of palliative home care. Psychooncology. 2012;21:886–895. doi: 10.1002/pon.1982. - DOI - PubMed
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical