PDF(Pubmed)
Abstract：
OBJECTIVE: Understand how physicians\' uncertainty tolerance (UT) in clinical care relates to their personal characteristics, perceptions and practices regarding shared decision making (SDM).
METHODS: As part of a trial of SDM training about colorectal cancer screening, primary care physicians (n = 67) completed measures of their uncertainty tolerance in medical practice (Anxiety subscale of the Physician\'s Reactions to Uncertainty Scale, PRUS-A), and their SDM self-efficacy (confidence in SDM skills). Patients (N = 466) completed measures of SDM (SDM Process scale) after a clinical visit. Bivariate regression analyses and multilevel regression analyses examined relationships.
RESULTS: Higher UT was associated with greater physician age (p = .01) and years in practice (p = 0.015), but not sex or race. Higher UT was associated with greater SDM self-efficacy (p < 0.001), but not patient-reported SDM.
CONCLUSIONS: Greater age and practice experience predict greater physician UT, suggesting that UT might be improved through training, while UT is associated with greater confidence in SDM, suggesting that improving UT might improve SDM. However, UT was unassociated with patient-reported SDM, raising the need for further studies of these relationships.
CONCLUSIONS: Developing and implementing training interventions aimed at increasing physician UT may be a promising way to promote SDM in clinical care.
METHODS: As part of a trial of SDM training about colorectal cancer screening, primary care physicians (n = 67) completed measures of their uncertainty tolerance in medical practice (Anxiety subscale of the Physician\'s Reactions to Uncertainty Scale, PRUS-A), and their SDM self-efficacy (confidence in SDM skills). Patients (N = 466) completed measures of SDM (SDM Process scale) after a clinical visit. Bivariate regression analyses and multilevel regression analyses examined relationships.
RESULTS: Higher UT was associated with greater physician age (p = .01) and years in practice (p = 0.015), but not sex or race. Higher UT was associated with greater SDM self-efficacy (p < 0.001), but not patient-reported SDM.
CONCLUSIONS: Greater age and practice experience predict greater physician UT, suggesting that UT might be improved through training, while UT is associated with greater confidence in SDM, suggesting that improving UT might improve SDM. However, UT was unassociated with patient-reported SDM, raising the need for further studies of these relationships.
CONCLUSIONS: Developing and implementing training interventions aimed at increasing physician UT may be a promising way to promote SDM in clinical care.
摘要：
目的：了解临床护理中医生的不确定性容忍度（UT）与他们的个人特征之间的关系，关于共享决策(SDM)的看法和实践。
方法：作为关于结直肠癌筛查的SDM培训试验的一部分，初级保健医生(n=67)完成了他们在医疗实践中的不确定性容忍度的测量(医生对不确定性量表的反应的焦虑子量表，PRUS-A),和他们的SDM自我效能感(对SDM技能的信心)。患者(N=466)在临床访问后完成了SDM(SDM过程量表)的测量。双变量回归分析和多水平回归分析检查了关系。
结果：较高的UT与较高的医生年龄（p=0.01）和实践年限（p=0.015）有关。但不是性别或种族.较高的UT与较高的SDM自我效能感相关(p<0.001)，但不是患者报告的SDM。
结论：年龄和实践经验越大，医师UT越大，这表明UT可能会通过培训得到改善，虽然UT与SDM的更大信心相关联，这表明改善UT可能会改善SDM。然而,UT与患者报告的SDM无关，需要进一步研究这些关系。
结论：制定和实施旨在提高医师UT的培训干预措施可能是在临床护理中推广SDM的有希望的方法。
方法：作为关于结直肠癌筛查的SDM培训试验的一部分，初级保健医生(n=67)完成了他们在医疗实践中的不确定性容忍度的测量(医生对不确定性量表的反应的焦虑子量表，PRUS-A),和他们的SDM自我效能感(对SDM技能的信心)。患者(N=466)在临床访问后完成了SDM(SDM过程量表)的测量。双变量回归分析和多水平回归分析检查了关系。
结果：较高的UT与较高的医生年龄（p=0.01）和实践年限（p=0.015）有关。但不是性别或种族.较高的UT与较高的SDM自我效能感相关(p<0.001)，但不是患者报告的SDM。
结论：年龄和实践经验越大，医师UT越大，这表明UT可能会通过培训得到改善，虽然UT与SDM的更大信心相关联，这表明改善UT可能会改善SDM。然而,UT与患者报告的SDM无关，需要进一步研究这些关系。
结论：制定和实施旨在提高医师UT的培训干预措施可能是在临床护理中推广SDM的有希望的方法。
