Physicians' reactions to uncertainty in the context of shared decision making.
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).


CONCLUSIONS
Variables associated with anxiety from uncertainty differ from those associated with reluctance to disclose uncertainty to patients.


CONCLUSIONS
Given the importance of communicating uncertainty during SDM, measuring physicians' reactions to uncertainty is essential in SDM implementation studies.
Politi
Mary C
MC
Department of Surgery, Washington University School of Medicine, St. Louis, MO 63112-1408, USA. mpoliti@wustl.edu
Légaré
France
F
D000328:Adult; D001007:Anxiety / Q000523:psychology; D003430:Cross-Sectional Studies; D003657:Decision Making; D030881:Disclosure; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010358:Patient Participation; D010817:Physician-Patient Relations; D010820:Physicians / Q000523:psychology*; D010818:Practice Patterns, Physicians'; D011320:Primary Health Care; D035501:Uncertainty