Department of Natural and Applied Sciences, Bentley University, Waltham, USA.
Amsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health, Amsterdam, The Netherlands.
Patient Educ Couns. 2019 Sep;102(9):1613-1620. doi: 10.1016/j.pec.2019.05.002. Epub 2019 May 2.
Physicians are increasingly expected to share uncertain information, yet there is concern about possible negative effects on patients. How uncertainty is conveyed and by whom may influence patients' response. We tested the effects of verbally and non-verbally communicating uncertainty by a male vs. female oncologist on patients' trust and intention to seek a second opinion.
In an experimental video vignettes study conducted in The Netherlands, oncologist communication behavior (verbal vs. non-verbal and high vs. low uncertainty) and gender (male vs. female) were systematically manipulated. Former cancer patients viewed one video variant and reported trust, intention to seek a second opinion, and experience of uncertainty.
Non-verbal communication of high uncertainty by the oncologist led to reduced trust (β = -0.72 (SE = 0.15), p < .001) and increased intention to seek a second opinion (β = 0.67 (SE = 0.16), p < .001). These effects were partly explained by patients' increased experience of uncertainty (β = -0.48 (SE = 0.12), p < .001; and β = 0.34 (SE = 0.09), p < .001 respectively). Neither verbal uncertainty nor oncologists' gender influenced trust or intention to seek a second opinion.
Non-verbal communication of uncertainty by oncologists may affect patient trust and intention to seek a second-opinion more than verbal communication.
Further research to understand and improve oncologists' non-verbal uncertainty behavior is warranted.
医生越来越被期望分享不确定的信息，但人们担心这可能对患者产生负面影响。信息是如何传达的以及由谁传达可能会影响患者的反应。我们通过男性和女性肿瘤医生口头和非口头传达不确定性来测试对患者信任和寻求第二意见意愿的影响。
在荷兰进行的一项实验性视频短片研究中，系统地操纵了肿瘤医生的沟通行为（口头与非口头以及高与低不确定性）和性别（男性与女性）。前癌症患者观看了一个视频变体，并报告了信任、寻求第二意见的意愿和不确定性体验。
肿瘤医生非口头传达的高不确定性导致信任度降低（β= -0.72（SE= 0.15），p<0.001），寻求第二意见的意愿增加（β= 0.67（SE= 0.16），p<0.001）。这些影响部分归因于患者体验到的不确定性增加（β= -0.48（SE= 0.12），p<0.001；β= 0.34（SE= 0.09），p<0.001）。口头不确定性和肿瘤医生的性别均未影响信任度或寻求第二意见的意愿。
肿瘤医生非口头传达的不确定性可能比口头沟通更能影响患者的信任度和寻求第二意见的意愿。
需要进一步研究以了解和改善肿瘤医生的非言语不确定性行为。
