Department of Medical Psychology, Amsterdam UMC, Amsterdam Public Health, Amsterdam, The Netherlands.
Medical Decision Making, Department of Biomedical Data Sciences, Leiden University Medical Center, Leiden, The Netherlands.
Health Expect. 2021 Aug;24(4):1025-1043. doi: 10.1111/hex.13255. Epub 2021 Jun 8.
Health-care providers increasingly have to discuss uncertainty with patients. Awareness of uncertainty can affect patients variably, depending on how it is communicated. To date, no overview existed for health-care professionals on how to discuss uncertainty.
To generate an overview of available recommendations on how to communicate uncertainty with patients during clinical encounters.
A scoping review was conducted. Four databases were searched following the PRISMA-ScR statement. Independent screening by two researchers was performed of titles and abstracts, and subsequently full texts.
Any (non-)empirical papers were included describing recommendations for any health-care provider on how to orally communicate uncertainty to patients.
Data on provided recommendations and their characteristics (eg, target group and strength of evidence base) were extracted. Recommendations were narratively synthesized into a comprehensible overview for clinical practice.
Forty-seven publications were included. Recommendations were based on empirical findings in 23 publications. After narrative synthesis, 13 recommendations emerged pertaining to three overarching goals: (a) preparing for the discussion of uncertainty, (b) informing patients about uncertainty and (c) helping patients deal with uncertainty.
A variety of recommendations on how to orally communicate uncertainty are available, but most lack an evidence base. More substantial research is needed to assess the effects of the suggested communicative approaches. Until then, health-care providers may use our overview of communication strategies as a toolbox to optimize communication about uncertainty with patients.
Results were presented to stakeholders (physicians) to check and improve their practical applicability.
医疗保健提供者越来越需要与患者讨论不确定性。对不确定性的认识会根据沟通方式的不同而对患者产生不同的影响。迄今为止，尚无针对医疗保健专业人员的概述，说明如何在临床就诊时与患者讨论不确定性。
生成一份关于在临床就诊期间与患者沟通不确定性的现有建议概述。
按照 PRISMA-ScR 声明进行了范围综述。在四个数据库中进行了搜索。两名研究人员独立筛选了标题和摘要，然后是全文。
任何（非）经验性论文都被纳入，描述了针对任何医疗保健提供者的建议，即如何口头向患者传达不确定性。
提取了提供的建议及其特征（例如，目标人群和证据基础的强度）的数据。建议以通俗易懂的临床实践概述进行叙述性综合。
共纳入 47 篇文献。23 篇文献中的建议基于经验发现。经过叙述性综合，出现了 13 条建议，涉及三个总体目标：（a）为讨论不确定性做准备，（b）告知患者有关不确定性的信息，（c）帮助患者应对不确定性。
有各种各样关于如何口头沟通不确定性的建议，但大多数都缺乏证据基础。需要进行更实质性的研究来评估所建议的沟通方法的效果。在此之前，医疗保健提供者可以将我们的沟通策略概述用作工具包，以优化与患者讨论不确定性。
将结果呈现给利益相关者（医生），以检查和提高其实际适用性。
