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Title: Exploring the relationships between attachment styles, emotional intelligence and patient-provider communication
Author: Cherry, Mary Gemma
Awarding Body: University of Liverpool
Current Institution: University of Liverpool
Date of Award: 2013
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Background: Patient-provider communication (PPC) influences patients’ health trajectories and general well-being, and its principles are taught and assessed during UK medical education. However, providers differ in their PPC, specifically of emotive issues. Two psychological characteristics have been proposed as potential influencers of PPC: attachment style and emotional intelligence (EI). Aim: To explore the relationships between providers’ attachment styles, EI and PPC. Procedures: Three empirical studies were conducted in one UK medical school/deanery. Study 1 investigated the influence of 1st year medical students’ (n = 200) attachment styles and EI on their PPC in an Objective Structured Clinical Examination (OSCE). Study 2 replicated Study 1 with 2nd year medical students, consulting in a more ‘demanding’ OSCE (n = 296). Study 3 studied junior doctors (n = 26) consulting in General Practice with real patients (n = 173). Attachment was assessed using the Experiences in Close Relationships: Short Form questionnaire, whilst EI was assessed with the Mayer-Salovey-Caruso Emotional Intelligence Test. PPC was assessed using OSCE checklists (Studies 1 and 2) and a patient satisfaction measure (Study 3). Consultations were videoed and coded with the Verona Coding Definition of Emotional Sequences, which quantifies patients’ expressions of emotion and associated provider responses. Analyses: Data were analysed using structural equation modelling (Studies 1 and 2) and multilevel modelling (Study 3). Results: In all studies, providers’ attachment styles and EI influenced their PPC. In Studies 1 and 2, EI mediated the influence of attachment on PPC, accounting for 7% and 14% of the variance in students’ OSCE scores respectively. In Study 3, doctors’ attachment and EI influenced the number of emotive cues received from patients; neither influenced patient satisfaction. Limited relationships were observed between providers’ attachment or EI and their responses to patients’ emotions across all studies. Conclusions/Implications: Attachment and EI independently influence PPC, but EI may mediate the negative influence of attachment. Whilst attachment is relatively stable throughout the life course, EI can be developed throughout undergraduate medical education, thus these data have potential educational implications. Further research is recommended to explore and validate these findings within the wider context of the clinical encounter.
Supervisor: O'Sullivan, Helen; Fletcher, Ian Sponsor: Not available
Qualification Name: Thesis (Ph.D.) Qualification Level: Doctoral
Keywords: RC0321 Neuroscience. Biological psychiatry. Neuropsychiatry