The interplay between shared decision making and uncertainty - a conceptual analysis and empirical illustration

Area of Science:

• Decision-making in healthcare
• Patient-clinician communication
• Health psychology

Background:

• Shared decision making (SDM) is crucial when treatment options present uncertainty.
• Both clinicians and patients experience uncertainty during SDM.
• The intersection of SDM and uncertainty requires further exploration.

Purpose of the Study:

• To conceptually describe how uncertainty manifests and impacts clinicians and patients in SDM.
• To empirically illustrate the expression and negotiation of uncertainty during treatment decision-making.

Main Methods:

• Literature search on uncertainty in SDM.
• Explorative analysis of videotaped oncology consultations.
• Microanalysis of clinician-patient interactions focusing on uncertainty.

Main Results:

• Patient involvement in SDM involves a mutual exchange of uncertainty between clinicians and patients.
• Clinicians and patients actively clarify their uncertainty perceptions.
• Clinicians employ strategies to negotiate uncertainty, though consensus achievement remains unclear.

Conclusions:

• This study enhances understanding of the interplay between uncertainty and SDM.
• Addressing and negotiating uncertainty are vital for effective patient participation in SDM.
• SDM training should equip clinicians to manage shared understanding of uncertainty.