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Attachment Patterns Affect Spiritual Coping in Palliative Care

Kunsmann-Leutiger, Elke, BA; Loetz, Cécile, PhD; Frick, Eckhard, MD, MA; Petersen, Yvonne, MD; Müller, Jakob Johann, PhD

Journal of Hospice & Palliative Nursing: August 2018 - Volume 20 - Issue 4 - p 385–391
doi: 10.1097/NJH.0000000000000455
Feature Articles

Research has shown that spiritual coping is essential for palliative care patients in enhancing quality of life and that attachment patterns affect the emotional well-being of the terminally ill. This is the first study evaluating how spiritual coping and attachment are associated in palliative care patients. Four different attachment patterns—secure, dismissive, preoccupied, and unresolved—were examined, as well as how they relate to three different spiritual coping strategies—search, trust, and reflection. In a cross-sectional, correlative design, 80 patients were recruited from German palliative care wards and hospices. Attachment patterns were determined using the Adult Attachment Projective System and spiritual coping strategies by SpREUK questionnaire, measuring spiritual and religious attitudes in dealing with illness. The results indicate that there is an association between attachment style and spiritual coping. Preoccupied patients had the lowest score in spiritual coping, with the strategy “reflection” being significantly lowest (t = 2.389, P = .019). Securely and dismissively attached patients presented equally high scores, raising the question of what mechanisms underlie spiritual coping. Furthermore, the unresolved group scored high in spiritual coping. Heightening awareness for ways in which attachment styles influence spiritual coping can contribute significantly to the quality of life in terminally ill patients, enabling health care professionals to tailor to individual needs in this vulnerable stage of life.

Elke Kunsmann-Leutiger, BA, is medical student, Ludwig-Maximilian University; and Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Munich, Germany.

Cécile Loetz, PhD, is psychologist, Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Germany.

Eckhard Frick, MD, MA, is professor, Department of Psychosomatic Medicine and Psychotherapy Technical University of Munich; and Munich School of Philosophy, Germany.

Yvonne Petersen, MD, is doctor for internal medicine and palliative care, Krankenhaus der Barmherzigen Brüder, München, Germany.

Jakob Johann Müller, PhD, is psychologist, Department of Psychosomatic Medicine and Psychotherapy, Technical University of Munich, Germany.

Address correspondence to Elke Kunsmann-Leutiger, BA, Klinikum Rechts der Isar Technische Universität München, Langerstr 3, 81675 München, Germany (chandrakala@gmx.de).

This study was funded by the Köhler Foundation, Germany, which is a member of the Association for the Promotion of German Science and Humanities.

The authors have no conflicts of interest to disclose.

© 2018 by The Hospice and Palliative Nurses Association.