BMJ. In this process, stigma creates the conditions which challenge expected power relations ( Fig. BMJ Qual Saf. In primary care ethics. 2011;16:362–72.Beresford EB. Motiv Emot. 2016;11:e0148991.
The three levels of diagnostic uncertainty discussed in this review are helpful in providing a platform for the development of such training and further research in this area.Clinicians in primary medical care are routinely confronted with diagnostic uncertainties. In this context, we ask how consumers in Ghana manage uncertainty in medicine quality, and how they come to trust enough to purchase and ingest a medicine. skills, strategies, or individual traits, or external: i.e. ► Discomfort with uncertainty leads clinicians to reinforce medical authority with stigma. However we highlight how the extant literature can be conceptualised into cognitive, emotional and ethical aspects of uncertainty which may help clinicians be more aware of their own biases as well as provide a platform for future research.Diagnostic uncertainty is one of the largest contributory factors to the occurrence of diagnostic errors across most specialties in medicine [Cognitive reactions are related to difficulties in perception and interpretation of the available facts [Emotional reactions include both short and long-term stress and/or anxiety which can develop under particular uncertain or ambiguous situations and contexts [Ethical reactions relate to the nature of discourse between the physician and patient in relation to uncertainty and encompass elements of shared decision-making [At a dyadic level, a physician’s ability to deal with uncertainty at a cognitive, emotional and ethical level influences the eventual diagnostic decision and therefore can impact on the patient and their outcomes [In summary, diagnostic uncertainty has implications for the primary care practitioner, their patients and the wider healthcare system.
Personality traits and characteristics influenced each of the three domains.There is little empirical evidence on how uncertainty is managed in general practice. © 2020 BioMed Central Ltd unless otherwise stated. 2009;14:66–7.Griffiths F, Green E, Tsouroufli M. The nature of medical evidence and its inherent uncertainty for the clinical consultation: qualitative study. 2000;283:2579–84.Tsiga E, Panagopoulou E: Risking your health while saving lives? 2013;13:1–6.Schneider A, Wubken M, Linde K, Buhner M. Communicating and dealing with uncertainty in general practice: the association with neuroticism. 2007;22:246–52.Kennedy AG: Managing uncertainty in diagnostic practice. Br J Gen Pract. National institute for health and care excellence Available online at Armstrong N, Hilton P. Doing diagnosis: whether and how clinicians use a diagnostic tool of uncertain clinical utility. For example, the use of DDX tools for cognitive aspects of diagnostic uncertainty, there is no evidence to say whether DDX tools do in fact do this. Dr Ashley Graham Kennedy. Physicians' reactions to uncertainty: refining the constructs and scales. JAMA. Furthermore, only one external resource/intervention was identified, a training programme, which although acceptable to clinicians reported no evidence on its effectiveness in helping clinicians to better manage their diagnostic uncertainties.Clinicians in primary care manage and deal with diagnostic uncertainty in a wide variety of ways.
Managing uncertainty and establishing authority – the theory Establishing authority is the central social process identified during analysis of the qualitative data. Fam Pract. Education/communication approach—communication is key to all patient interactions and this is no … A typology of reviews: an analysis of 14 review types and associated methodologies. It is not just about factual knowledge. We do not capture any email address. The current attempt to “kill” uncertainty in our society risks removing from the medical profession some important “tools of the trade” and placing obstacles in their way. ► Functional theories of stigma should incorporate the role of power relations.We use cookies to help provide and enhance our service and tailor content and ads. Psychiatr Bull. Despite the heterogeneity with regards to their study designs and aims, the studies nonetheless provide some empirical evidence on the types of diagnostic uncertainty currently studied in the literature (emotional, ethical and cognitive) and the impact of specific characteristics on how diagnostic uncertainty manifests and on how diagnostic uncertainty is managed.Eight studies reported on various cognitive aspects of managing uncertainty [Across the qualitative studies, two studies focused on the consideration of the individual patient and their unique biological, psychological and social situations whereby greater knowledge regarding the patient was one strategy by which diagnostic uncertainty could be reduced [The results of four quantitative cross-sectional studies [Eight of the studies also briefly alluded to different emotional precursors and responses to managing uncertainty [Accepting diagnostic uncertainty as an inevitable part of general practice and going with a provisional decision including using intuition and gut feelings was one strategy discussed across several qualitative and cross-sectional studies [Eight studies highlighted ethical aspects of diagnostic uncertainty management [The negative impact of failures on disclosing diagnostic uncertainty has also been evident in the qualitative data. Spain: Barcelona; 2003.Grant MJ, Booth A. Functional theories of stigma posit that we hold stigmatizing attitudes because they serve specific psychological functions. All authors critically revised the manuscript and provided important intellectual content. Patients, doctors, and the wider public need a better understanding of medicine’s limitationsUncertainty is ubiquitous in medicine. Health Expect. Intolerance to diagnostic uncertainty is increasingly acknowledged to have negative implications for the primary care practitioner, their patients and the wider healthcare system. Dealing with uncertainty in general practice: an essential skill for the general practitioner. Qual Prim Care.
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