Communicating uncertainty can lead to less decision satisfaction: a necessary cost of involving patients in shared decision making?

Background  Given the large number of interventions of uncertain effectiveness, research on communicating uncertainty is needed to examine its impact on patients’ health decisions. Objective  To examine physicians’ communication of uncertainty and its impact on patients’ decisions and decision satis...

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Bibliographic Details
Published in:Health expectations : an international journal of public participation in health care and health policy 2011-03, Vol.14 (1), p.84-91
Main Authors: Politi, Mary C., Clark, Melissa A., Ombao, Hernando, Dizon, Don, Elwyn, Glyn
Format: Article
Language:English
Subjects:
Adult
Aged
Aged, 80 and over
Breast cancer
Breast Neoplasms - surgery
Cancer
Cancer therapies
Communication
Decision Making
decision support
Doctor-Patient communication
Doctors
Female
Generalized linear models
Group decision making
Health care
Health care facilities
Health facilities
Health status
Humans
Internal medicine
Mammography
Middle Aged
Original Research Papers
Patient education
Patient participation
Patient Participation - psychology
Patient Satisfaction
patient-physician communication
Patients
Physicians
Severity of Illness Index
shared decision making
Socioeconomic Factors
Uncertainty
Women
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Summary:Background  Given the large number of interventions of uncertain effectiveness, research on communicating uncertainty is needed to examine its impact on patients’ health decisions. Objective  To examine physicians’ communication of uncertainty and its impact on patients’ decisions and decision satisfaction. Design, setting, and participants  Participants included female patients seen in a breast health centre whose physicians were discussing a decision with them, with no clear ‘best’ choice based on outcome evidence. Main variables  Decision communication was measured using the OPTION scale, a measure of the degree to which physicians involve patients in a decision‐making process. One‐to‐two weeks after the discussion, patients reported their satisfaction with the decision‐making process and their decision. Decisions were verified in medical charts with patient consent. Results  Seventy‐five women agreed to participate (94% response rate). The mean translated score of the OPTION scale was 68.0 (SD 18.3), but only 33.2 (SD 19.1) for the uncertainty items. Among cancer patients, communicating uncertainty was negatively related to decision satisfaction (P 
ISSN:1369-6513
1369-7625
DOI:10.1111/j.1369-7625.2010.00626.x