title: Approaches to managing uncertainty in people with life-limiting conditions: role of communication and palliative care.
abstract: Patients with any major illness can expect to experience uncertainty about the nature of their illness, its treatment and their prognosis. Prognostic uncertainty is a particular source of patient distress among those living with life-limiting disease. Uncertainty also affects professionals and it has been argued that the level of professional tolerance of uncertainty can affect levels of investigation as well as healthcare resource use. We know that the way in which uncertainty is recognised, managed and communicated can have important impacts on patients' treatment and quality of life. Current approaches to uncertainty in life-limiting illness include the use of care bundles and approaches that focus on communication and education. The experience in communicating in difficult situations that specialist palliative care professionals can provide may also be of benefit for patients with life-limiting illness in the context of uncertainty. While there are a number of promising approaches to uncertainty, as yet few interventions targeted at recognising and addressing uncertainty have been fully evaluated and further research is needed in this area.
authors.affiliation: Department of Palliative Care, Policy and Rehabilitation, King's College London, Cicely Saunders Institute, London, UK.
authors.forename: S N
authors.initials: SN
authors.lastname: Etkind
authors.affiliation: Department of Palliative Care, Policy and Rehabilitation, King's College London, Cicely Saunders Institute, London, UK.
authors.forename: J
authors.initials: J
authors.lastname: Koffman
mesh_terms: D001291:Attitude of Health Personnel; D016638:Critical Illness / Q000523:psychology / Q000628:therapy; D006801:Humans; D010166:Palliative Care / Q000379:methods / Q000523:psychology / Q000592:standards; D011369:Professional-Patient Relations; D011379:Prognosis; D011788:Quality of Life; D035501:Uncertainty
keywords: EDUCATION & TRAINING (see Medical Education & Training); INTERNAL MEDICINE