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A qualitative exploration of clinicians' strategies to communicate risks to patients in the complex reality of clinical practice
- Source :
- PLOS ONE, 15(8):0236751. Public Library of Science, PLoS ONE, Vol 15, Iss 8, p e0236751 (2020), PLoS ONE
- Publication Year :
- 2020
-
Abstract
- Background Risk communication, situated in the model of shared decision making (SDM), is an essential element in daily clinical practice. The scientific literature makes a number of generic recommendations. Yet the application of risk communication remains a challenge in patient-clinician encounters. How clinicians actually communicate risk during consultations is not well understood. We aimed to explore the risk communication strategies used by clinicians and extract narratives and visualizations of those strategies to help inform medical education. Methods In this qualitative descriptive study, we interviewed fifteen purposely sampled clinicians from several medical disciplines, who were familiar with the concept of SDM. Deductive and inductive content analysis was used during an iterative data collection and analyses process. Results Our study identified various strategies reported to be used by clinicians to address the complexities of risk communication such as dealing with uncertainty. These included verbal, numerical and visual risk communication and framing. Clinicians were familiar with recommended risk formats such as natural frequencies and population pictograms. However, it became clear that clinicians' expertise and communication goals also play an important role in the risk talk. Clinicians try to lay a foundation for balanced decision-making and to incorporate patient preferences while faced with several challenges such as the dilemma of raising awareness but triggering anxiety or fan fear in patients. Consequently, they also use communication goals such as influencing mindset and reassuring patients. Additionally, clinicians frequently have to account for the illusion of certainty in the risk talk. Conclusion Risk communication is a multi-faceted construct that cannot be dealt with in isolation from the clinical context. For future research we recommend considering a more practical framework within the clinical setting and to take a goal-directed approach into account when investigating and teaching the topic. The patient perspective should also be addressed in further research.
- Subjects :
- Male
Epidemiology
Health Care Providers
Cancer Treatment
Social Sciences
Mindset
UNCERTAINTY
Scientific literature
Cardiovascular Medicine
Pictogram
0302 clinical medicine
Medical Conditions
Cognition
Medicine and Health Sciences
Psychology
VISUAL AIDS
030212 general & internal medicine
Medical Personnel
CRISIS
Qualitative Research
media_common
Verbal Communication
education.field_of_study
HEALTH-RISK
NUMBERS
Multidisciplinary
030503 health policy & services
Communication
Cancer Risk Factors
Certainty
Middle Aged
Professions
Oncology
Cardiovascular Diseases
Medicine
Female
0305 other medical science
Research Article
Adult
Risk
Attitude of Health Personnel
media_common.quotation_subject
Science
Population
Decision Making
Cardiology
Surgical and Invasive Medical Procedures
FREQUENCY
Interviews as Topic
HEURISTICS
03 medical and health sciences
Physicians
Humans
NUMERACY
education
Aged
Medical education
Physician-Patient Relations
Behavior
Verbal Behavior
Cognitive Psychology
Biology and Life Sciences
Cardiovascular Disease Risk
FORMATS
Dilemma
Health Care
Framing (social sciences)
Content analysis
Medical Risk Factors
People and Places
Cognitive Science
Population Groupings
SHARED DECISION-MAKING
Neuroscience
Subjects
Details
- Language :
- English
- ISSN :
- 19326203
- Database :
- OpenAIRE
- Journal :
- PLOS ONE, 15(8):0236751. Public Library of Science, PLoS ONE, Vol 15, Iss 8, p e0236751 (2020), PLoS ONE
- Accession number :
- edsair.doi.dedup.....d34c756c63ea538ac2942eb48847dbe1