Quality of communication with patients and difficulties in close relationships among health care workers during the COVID-19 pandemic

Introduction
Communication is a skill and its quality is associated with adult attachment styles. This study aimed to assess the association between self-reported quality of health care workers’ (HCWs) communication with their patients and HCWs’ attachment styles and personal relationship status and quality during the COVID-19 pandemic in Poland.

Material and methods
Two thousand three hundred three HCWs participated in the online survey conducted in all voivodeships in Poland in early 2022, including 1791 individuals living in close relationships (defined as being in a relationship for at least six months). The study explored this association among four groups of HCWs: physicians (n = 498), nurses (n = 1216), paramedics (n = 166), others (n = 423). Communication competencies were evaluated using the 12-item Health Professionals Communication Scale (HPCSS-12) (range 12-72) measuring empathy, informative communication, respect, and social skills. The quality of the HCWs’ relationships was examined using Experiences in Close Relationships – Revised Scale (ECR-RS), which measures security of attachment.

Results
The overall mean HPCSS-12 index was 59.58 ± 7.36, with a significant difference between physicians according to their relationship status. Problems in relationships were reported by 24.5% of respon­dents, ranging from 21.2% among physicians to 31.7% among paramedics. HCWs reporting a less secure attachment style scored 2.73 points lower on the HP-CSS scale as compared to those with no such problems (p < 0.001). In males, having good and secure relationships was associated with better communication particularly among the group of other HCWs (64.55 ± 7.05) and in paramedics (61.83 ± 3.94). Also, high HPCSS-12 values were achieved by female physicians and other female professionals living in secure relationships (61.61 ± 7.13 and 61.04 ± 6.30, respectively).

Conclusions
Health care providers should be aware that the quality of HCW-patient communication is not only associated with gender, age, or occupational group, but also with the HCW’s personal situation in a family or other close relationship.