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Epistemology and uncertainty in primary care: an exploratory study
Lance Evans1, David R M Trotter
1Texas Tech University Health Sciences Center, Department of Family and Community Medicine, 3601 4th Street, Lubbock, TX 79430-8143, USA. lance.evans@ttuhsc.edu
Family Medicine
|May 7, 2009
Summary
Primary care physicians with a biopsychosocial approach experience less stress from clinical uncertainty. Conversely, a biomedical epistemology correlates with increased stress reactions for these doctors.
Area of Science:
- Medical Education
- Psychology
- Primary Care Medicine
Background:
- Primary care is characterized by high clinical uncertainty, unlike most other medical specialties.
- Clinical uncertainty is linked to negative economic and clinical outcomes.
- Physicians utilize cognitive resources and experience affective stress reactions when facing uncertainty.
Purpose of the Study:
- To investigate the relationship between primary care physicians' stress reactions to uncertainty and their epistemological framework.
- To understand how physicians' beliefs about knowledge influence their response to uncertainty.
Main Methods:
- A cross-sectional survey was administered to 78 primary care physicians (board-certified and residents).
- Likert-type scales measured epistemology and stress reactions to uncertainty.
- Bivariate and multivariate regression analyses were employed to assess the relationship, controlling for demographic and professional factors.
Main Results:
- A significant relationship was found between physician epistemology and stress reactions to uncertainty in both bivariate and multivariate models.
- The findings indicate that epistemology independently influences stress responses.
Conclusions:
- A biopsychosocial epistemology is associated with reduced stress reactions when confronting uncertainty in primary care.
- A biomedical epistemology is associated with increased stress reactions to uncertainty among primary care physicians.
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