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Medline ® Abstract for Reference 29

of 'Palliative care: Medically futile and potentially inappropriate therapies of questionable benefit'

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Physicians' reactions to uncertainty in the context of shared decision making.
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Politi MC, LégaréF
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Patient Educ Couns. 2010 Aug;80(2):155-7. Epub 2009 Nov 30.
 
OBJECTIVE: Physicians' reactions towards uncertainty may influence their willingness to engage in shared decision making (SDM). This study aimed to identify variables associated with physician's anxiety from uncertainty and reluctance to disclose uncertainty to patients.
METHODS: We conducted a cross-sectional secondary analysis of longitudinal data of an implementation study of SDM among primary care professionals (n=122). Outcomes were anxiety from uncertainty and reluctance to disclose uncertainty to patients. Hypothesized factors that would be associated with outcomes included attitude, social norm, perceived behavioral control, intention to implement SDM in practice, and socio-demographics. Stepwise linear regression was used to identify predictors of anxiety from uncertainty and reluctance to disclose uncertainty to patients.
RESULTS: In multivariate analyses, anxiety from uncertainty was influenced by female gender (beta=0.483; p=0.0039), residency status (1st year: beta=0.600; p=0.001; 2nd year: beta=0.972; p<0.001), and number of hours worked per week (beta=-0.012; p=0.048). Reluctance to disclose uncertainty to patients was influenced by having more years in formal education (beta=-1.996; p=0.012).
CONCLUSION: Variables associated with anxiety from uncertainty differ from those associated with reluctance to disclose uncertainty to patients.
PRACTICE IMPLICATIONS: Given the importance of communicating uncertainty during SDM, measuring physicians' reactions to uncertainty is essential in SDM implementation studies.
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Department of Surgery, Washington University School of Medicine, St. Louis, MO 63112-1408, USA. mpoliti@wustl.edu
PMID