University of Queensland, Brisbane, QLD.
Australian Women and Girls' Health Research (AWaGHR) Centre, University of Queensland, Brisbane, QLD.
Med J Aust. 2023 May 15;218(9):418-425. doi: 10.5694/mja2.51925. Epub 2023 Apr 23.
Clinicians must make decisions amid the uncertainty that is ubiquitous to clinical practice. Uncertainty in clinical practice can assume many forms depending on its source, such as insufficient personal knowledge or scientific evidence, limited practical understanding or competence, challenging interpersonal relationships, and complexity and ambiguity in clinical encounters. The level and experience of uncertainty varies according to personal traits, clinical context, affective factors and sociocultural norms. Clinicians vary in their tolerance of uncertainty, and maladaptive responses may adversely affect patient care and clinician wellbeing. Various strategies can be used to minimise and manage, but not eliminate, uncertainty and to share uncertainty with patients without compromising the clinician-patient relationship or clinician credibility.
临床医生必须在普遍存在于临床实践中的不确定性中做出决策。不确定性在临床实践中可以呈现出多种形式,具体取决于其来源,例如个人知识或科学证据不足、实践理解或能力有限、人际关係具有挑战性,以及临床接触中的复杂性和模糊性。不确定性的程度和经验因个人特质、临床背景、情感因素和社会文化规范而异。临床医生对不确定性的容忍度各不相同,适应不良的反应可能会对患者护理和临床医生的健康产生不利影响。可以使用各种策略来最小化和管理不确定性,但无法完全消除不确定性,并与患者分享不确定性,而不会损害医患关系或临床医生的信誉。