Managing uncertainty in conversations about treatment preferences: A study of home health care nurses

Abstract

Inappropriate efforts to manage uncertainty may account for difficulties associated with communication about serious illness. This study tested a series of predictions concerning the relationship between the amount of uncertainty associated with a communicative task and health care providers’ comfort levels when engaging in that task. A mailed survey of 540 home health care nurses confirmed expectations that discussions of future or more serious health problems will create more discomfort than discussions of present or less serious problems, that unstructured conversations produce more discomfort than structured discussions, and that comfort discussing serious illness would be positively associated with extent of communication about patients’ treatment preferences and the likelihood of learning these preferences.