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Clinicians' tolerance for uncertainty and communication about uncertainty with older adults -a standardized patient assessment study.

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Τίτλος: Clinicians' tolerance for uncertainty and communication about uncertainty with older adults -a standardized patient assessment study.
Συγγραφείς: Hillen M; Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, P.O. Box 22660, Amsterdam, 1100DD, The Netherlands. m.a.hillen@amsterdamumc.nl.; Quality of Care, Amsterdam Public Health, Amsterdam, The Netherlands. m.a.hillen@amsterdamumc.nl., Nijskens C; Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Wezeman S; Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, P.O. Box 22660, Amsterdam, 1100DD, The Netherlands., Franssen R; Department of Internal Medicine, Amsterdam UMC, University of Amsterdam, Amsterdam, The Netherlands., Smets E; Department of Medical Psychology, Amsterdam UMC, University of Amsterdam, P.O. Box 22660, Amsterdam, 1100DD, The Netherlands.; Quality of Care, Amsterdam Public Health, Amsterdam, The Netherlands.
Πηγή: BMC geriatrics [BMC Geriatr] 2025 Dec 08; Vol. 26 (1), pp. 46. Date of Electronic Publication: 2025 Dec 08.
Τύπος έκδοσης: Journal Article; Observational Study
Γλώσσα: English
Στοιχεία περιοδικού: Publisher: BioMed Central Country of Publication: England NLM ID: 100968548 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2318 (Electronic) Linking ISSN: 14712318 NLM ISO Abbreviation: BMC Geriatr Subsets: MEDLINE
Imprint Name(s): Original Publication: London : BioMed Central, [2001]-
Ιατρικοί όροι (MeSH): Geriatric Assessment*/methods , Internship and Residency*/standards , Internship and Residency*/methods , Communication* , Physician-Patient Relations* , Uncertainty*, Adult ; Aged ; Aged, 80 and over ; Female ; Humans ; Male ; Middle Aged
Περίληψη: BACKGROUND: Uncertainty is omnipresent in care for older adults. Resident-physicians may be challenged to manage and communicate about such uncertainty. We aimed to 1) describe how resident-physicians discussed uncertainty with an older adult patient and involved them in decisions; and 2) assess how resident-physicians’ tolerance for uncertainty predicted communication about uncertainty and efforts towards patient involvement. METHODS: A video-recorded, standardized patient assessment study was conducted involving resident-physicians in internal medicine. Participants conducted online consultations with a standardized geriatric patient. Self-report questionnaires assessed participants’ tolerance for uncertainty, feelings of ambivalence, and satisfaction with communication. Systematic observational coding assessed how residents communicated about uncertainty and involved the patient in decision-making. Descriptive statistics and correlations between observed communication and self-report measures were tested. RESULTS: Residents (N = 37) expressed uncertainty on average 14 times per consultation (range 7–24), most often implicitly (67%). They primarily used information focused approaches (72%, e.g., explaining uncertainty). Emotion-focused approaches were scarcer (21%, e.g., facilitating patients’ coping with uncertainty). Tolerance for uncertainty was relatively high, and unrelated to residents’ uncertainty communication. Residents involved the patient in decision making to an acceptable degree. Patient involvement was not associated with residents’ uncertainty tolerance. Consultations with higher patient involvement included more frequent uncertainty expressions by residents (rp=0.38, p = .02). CONCLUSIONS: More solid evidence is needed on the relation between residents’ uncertainty tolerance and communication within care for older adult patients. Research evidence could guide reflective education to support residents in managing uncertainty, as well as skills training to enhance uncertainty communication.
Competing Interests: Declarations. Ethics approval and consent to participate: The work described in this manuscript was carried out in accordance with the Declaration of Helsinki. The study was exempted from the Medical Research Regulations Involving Human Subjects Act by the Medical Ethics Committee of Amsterdam University Medical Centers, location AMC (W20_425 # 20.472). All participants provided e-informed consent and anonymity of their data was guaranteed. Consent for publication: All authors agree with the final manuscript version and agree to be accountable for all aspects of the work. Competing interests: The authors declare no competing interests. Clinical trial number: not applicable.
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Grant Information: 016.veni.198.017 Nederlandse Organisatie voor Wetenschappelijk Onderzoek
Contributed Indexing: Keywords: Communication; Geriatrics; Observational coding; Patient-provider interaction; Physician-patient relation; Uncertainty
Entry Date(s): Date Created: 20251209 Date Completed: 20260626 Latest Revision: 20260724
Update Code: 20260725
PubMed Central ID: PMC12797895
DOI: 10.1186/s12877-025-06705-y
PMID: 41361772
Βάση Δεδομένων: MEDLINE
Περιγραφή
ISSN:1471-2318
DOI:10.1186/s12877-025-06705-y