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Sunday, 23 October 2005
29

VARIABLES ASSOCIATED WITH PHYSICIANS' ANXIETY AND RELUCTANCE TO SHARE UNCERTAINTY WITH PATIENTS IN THE CONTEXT OF SHARED DECISION MAKING

France Legare, MD, PhD, FCFP1, Lucile Turcot, MD, PhD1, Hubert Marcoux, MD, MSc1, Ian Graham, PhD2, and Annette M. O'Connor, PhD3. (1) Laval University, Quebec, QC, Canada, (2) Ottawa Health Research Institute, Ottawa, ON, Canada, (3) University of Ottawa, Ottawa, ON, Canada

Purpose: In the context of shared decision-making, providers need to explicitly acknowledge uncertainty with patients. However, physicians' reactions to uncertainty may influence their ability to do so. The aim of this study was to identify the socio-demographic variables which are associated with Physicians' Reactions to Uncertainty in a French-speaking sample of physicians. Methods: A cross-sectional survey was performed in a group of private practice as well as in a group of family practice teaching units in Québec, Canada. Two subscales from the Physicians' Reactions to Uncertainty (PRU) that had been translated in French were used: anxiety due to uncertainty (Cronbach =0.86) and reluctance to disclosing uncertainty to patients (Cronbach =0.79). Univariate analyses used: Pearson r correlation coefficient, Student's t test and ANOVA. Multivariate analyses used: the SAS GLM procedure. Results: 138 physicians (69 clinical teachers and 53 residents in family medicine and 16 physicians in private practice) enrolled in this study. In univariate analyses, younger age (p<0.0001), fewer hours worked per week (p=0.03), fewer patients seen per week (p=0.003), female (p<0.0001) and residency status (p<0.0001) were found to be positively associated with anxiety due to uncertainty but not with reluctance to disclosing uncertainty to patients. Having another diploma (p=0.01) was found to be negatively associated with reluctance to disclosing uncertainty to patients but not with anxiety due to uncertainty. In multivariate analyses, being a female (ß=0.483), a 1st year resident (ß=0.597) or a 2nd year resident (ß=0.972) and fewer hours worked per week (ß= - 0.012) explained 30% of the variance in the anxiety due to uncertainty score. Having another diploma (ß= - 1.996) explain 5% of the variance in the reluctance to disclosing uncertainty to patients score. Conclusions: Socio-demographic variables which are associated with anxiety due to uncertainty differed from those associated with reluctance to disclosing uncertainty to patients. In line with previous studies in this field, French-speaking female physicians experienced more anxiety due to uncertainty than their male counterparts. Number of hours worked per week and a residency status were also found to influence this type of anxiety. Having another diploma appeared to improve disclosure of uncertainty to patients. Therefore, those interested in implementing shared decision-making should tailor their interventions accordingly.

See more of Poster Session II
See more of The 27th Annual Meeting of the Society for Medical Decision Making (October 21-24, 2005)