Abstract
Talking about dying when faced with end-of-life may be important for achieving optimal outcomes for young people and their families. Given the lack of research on young people’s communication around end-of-life and death, this analogue study examined the role of attachment theory in conversations about dying. Experiment 1 assessed attachment security of 80 healthy young adults and randomised them to receive either an induction that raised awareness of one’s attachment figures or a neutral induction, and then primed them with an imagined scenario where they were diagnosed with an incurable illness. Participants then completed a self-report measure of their willingness to discuss end-of-life topics with family, friends, or a psychologist. The experimental attachment induction did not increase willingness to talk about end-of-life concepts. Experiment 2 extended this design and asked participants to describe these conversations and assessed the content of their imagined end-of-life conversations. Experiment 2 replicated the finding that enhancing individuals’ awareness of key attachment figures did not increase participants’ willingness to engage in end-of-life conversations. However, heightened attachment awareness led participants to talk more about their relationship with the person they were hypothetically talking with. Across both experiments, avoidant attachment tendencies reduced the likelihood that participants receiving the attachment prime would want to engage in end-of-life conversation. Overall, it seems there are important differences between individuals on willingness to talk about death, and this may be influenced by one’s attachment style. These results raise implications for the importance of attachment in the therapeutic relationship for healthcare professionals working with young people with life-limiting illnesses, such as cancer. Further research may shed light on how an individually tailored approach, taking into account attachment security, achieves the best outcomes for individuals who require end-of-life conversations.
Funder
Australian Government Research Training Program
HCF Foundation
National Health and Medical Research Council
Cancer Institute NSW
Publisher
Public Library of Science (PLoS)
Reference51 articles.
1. Cancer incidence and mortality among young adults aged 20–39 years worldwide in 2012: a population-based study.;MM Fidler;Lancet Oncol.,2017
2. Predictors of complicated grief: a systematic review of empirical studies.;EA Lobb;Death Stud.,2010
3. A longitudinal, randomized, controlled trial of advance care planning for teens with cancer: anxiety, depression, quality of life, advance directives, spirituality.;ME Lyon;J Adoles Health.,2014
4. Establishing psychosocial palliative care standards for children and adolescents with cancer and their families: An integrative review;MS Weaver;Palliat Med,2016
5. A summary of pediatric palliative care team structure and services as reported by centers caring for children with cancer;MS Weaver;J Palliative Med,2018