• Danielle Blanch-Hartigan, Marceline van Eeden, VerdamMathilde G EMGEAmsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health, Amsterdam, The Netherlands; Leiden University, Institute of Psychology, Leiden, The Netherlands., HanPaul K JPKJCenter for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, USA., SmetsEllen M AEMAAmsterdam UMC, University of Amsterdam, Department of Medical Psychology, Amsterdam Public Health, Amsterdam, The Netherlands., and Marij A Hillen.
• Department of Natural and Applied Sciences, Bentley University, Waltham, USA.
• Patient Educ Couns. 2019 Sep 1; 102 (9): 1613-1620.

ObjectivePhysicians are increasingly expected to share uncertain information, yet there is concern about possible negative effects on patients. How uncertainty is conveyed and by whom may influence patients' response. We tested the effects of verbally and non-verbally communicating uncertainty by a male vs. female oncologist on patients' trust and intention to seek a second opinion.MethodsIn an experimental video vignettes study conducted in The Netherlands, oncologist communication behavior (verbal vs. non-verbal and high vs. low uncertainty) and gender (male vs. female) were systematically manipulated. Former cancer patients viewed one video variant and reported trust, intention to seek a second opinion, and experience of uncertainty.ResultsNon-verbal communication of high uncertainty by the oncologist led to reduced trust (β = -0.72 (SE = 0.15), p < .001) and increased intention to seek a second opinion (β = 0.67 (SE = 0.16), p < .001). These effects were partly explained by patients' increased experience of uncertainty (β = -0.48 (SE = 0.12), p < .001; and β = 0.34 (SE = 0.09), p < .001 respectively). Neither verbal uncertainty nor oncologists' gender influenced trust or intention to seek a second opinion.ConclusionNon-verbal communication of uncertainty by oncologists may affect patient trust and intention to seek a second-opinion more than verbal communication.Practice ImplicationsFurther research to understand and improve oncologists' non-verbal uncertainty behavior is warranted.Copyright © 2019 Elsevier B.V. All rights reserved.

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