Relationship Between Secure and Insecure Attachment Style with Physician Empathy Among Medical Students: A Cross-sectional Study in Iran

Background: Physician empathy is one of the fundamental factors involved in patient care and it can enhance the therapeutic effects of patient-clinician relationships. Attachment is defined as the tendency of human beings to make strong affectional bonds with some specific people. Objectives: This study are aimed to examine the possible relationship between secure and insecure attachment style with physician empathy among medical students. Methods: A cross-sectional study was conducted on 268 medical students and residents at Mazandaran University of Medical Sciences, Iran in 2015. All participants voluntarily participated in this study and an informed consent was obtained. Data analysis was done through completing two questionnaires, including the Jefferson Scale of Physician Empathy-Health Professionals Version (JSPE-HP) and the Revised Adult Attachment Scale (RAAS). Data was analyzed using Pearson correlation coefficient and stepwise regression analysis and analyzed in SPSS (v. 18). Results: The highest frequency (n = 137; 51%) was related to individuals in the age range of 21 - 25 years. The empathy score of all students was 99.99. Among 268 participants, 76 (28.4%) and 192 (71.6%) students represented secure and insecure attachment styles, respectively. Married students had higher empathy scores than single students (P = 0.056). Nostatistically significant difference was found in the mean empathy scores by gender (P = 0.305) and different years of studying (P = 0.883). The mean +/- standard deviation of empathy score in psychiatry residents was 113.4 +/- 16.24, which was higher than the residents of other fields. Also, our results revealed no significant difference between the empathy scores in individuals with secure and insecure attachment styles (P = 0.945; 95% CI: -3.883 - 3.620). Conclusions: Evaluating empathy in the educational courses of medical students, as future physicians, can offer valuable guidelines to improve the mental health of students and help them have a good relationship with patients.