Doctor patient relationship as a mediator between attachment dimensions and self-management In chronic patients, Yangon, Myanmar

Abstract

This research studied the direct effect of attachment dimensions on self-management and the mediating effect of the doctor-patient relationship between attachment dimensions and self-management. A quantitative method with correlational research design via path analysis was utilized. The participants of the study consisted of 90 male and 90 female chronic patients. Burmese translated version of Revised Adult Attachment Scale (RAAS), Partners in Health (PIH) scale and Patient-Doctor Depth of Relationship (PDDR), and a researcher constructed demographic questionnaires were employed. The mediating role of doctor patient relationship is discussed in the context of self-management of chronic patients in Yangon, Myanmar. The results revealed the following major findings: (1) close attachment dimension had a significant direct positive effect on self-management, depend and anxiety attachment dimensions did not have a direct effect on self-management; (2) close attachment dimension had a significant indirect effect on self-management, being mediated by doctor-patient relationship (Standardized Indirect effect = .08, SE = .04, LLCI = .01, ULCI = .16), depend attachment dimension did not have a significant indirect effect on self-management, being mediated by doctor-patient relationship (Standardized Indirect Effect = .06, SE = .04, LLCI = -.01, ULCI = .14), anxiety attachment dimensions did not have a significant indirect effect on self-management, being mediated by doctor-patient relationship (Standardized Indirect Effect = .0361, SE = .03, LLCI = -.03, ULCI = .11); it is not uncommon for chronic patients in Myanmar to reach out to the quack doctors instead of consulting with doctors. Economic hardship requires chronic patients to make difficult decisions between healthcare and basic living expenses).