Tania D Strout1, Marij Hillen2, Caitlin Gutheil3, Eric Anderson3, Rebecca Hutchinson4, Hannah Ward5, Hannah Kay6, Gregory J Mills7, Paul K J Han3. 1. Department of Emergency Medicine, Maine Medical Center, Tufts University School of Medicine, 47 Bramhall Street, Portland, ME, 04102, USA. Electronic address: strout@mmc.org. 2. Department of Medical Psychology, Academic Medical Center, University of Amsterdam, Amsterdam, The Netherlands. 3. Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA. 4. Center for Outcomes Research and Evaluation, Maine Medical Center Research Institute, Portland, ME, USA; Hospice and Palliative Medicine, Maine Medical Center, Portland, ME, USA. 5. University of Rochester, School of Medicine & Dentistry, Rochester, NY, USA. 6. Dell Medical School, University of Texas at Austin, Austin, TX, USA. 7. University of Southern Maine, Portland, ME, USA.
Abstract
BACKGROUND: Uncertainty tolerance (UT) is thought to be a characteristic of individuals that influences various outcomes related to health, healthcare, and healthcare education. We undertook a systematic literature review to evaluate the state of the evidence on UT and its relationship to these outcomes. METHODS: We conducted electronic and bibliographic searches to identify relevant studies examining associations between UT and health, healthcare, or healthcare education outcomes. We used standardized tools to assess methodological quality and analyzed the major findings of existing studies, which we organized and classified by theme. RESULTS: Searches yielded 542 potentially relevant articles, of which 67 met inclusion criteria. Existing studies were heterogeneous in focus, setting, and measurement approach, were largely cross-sectional in design, and overall methodological quality was low. UT was associated with various trainee-centered, provider-centered, and patient-centered outcomes which were cognitive, emotional, and behavioral in nature. UT was most consistently associated with emotional well-being. CONCLUSIONS: Uncertainty tolerance is associated with several important trainee-, provider-, and patient-centered outcomes in healthcare and healthcare education. However, low methodological quality, study design limitations, and heterogeneity in the measurement of UT limit strong inferences about its effects, and addressing these problems is a critical need for future research.
BACKGROUND: Uncertainty tolerance (UT) is thought to be a characteristic of individuals that influences various outcomes related to health, healthcare, and healthcare education. We undertook a systematic literature review to evaluate the state of the evidence on UT and its relationship to these outcomes. METHODS: We conducted electronic and bibliographic searches to identify relevant studies examining associations between UT and health, healthcare, or healthcare education outcomes. We used standardized tools to assess methodological quality and analyzed the major findings of existing studies, which we organized and classified by theme. RESULTS: Searches yielded 542 potentially relevant articles, of which 67 met inclusion criteria. Existing studies were heterogeneous in focus, setting, and measurement approach, were largely cross-sectional in design, and overall methodological quality was low. UT was associated with various trainee-centered, provider-centered, and patient-centered outcomes which were cognitive, emotional, and behavioral in nature. UT was most consistently associated with emotional well-being. CONCLUSIONS: Uncertainty tolerance is associated with several important trainee-, provider-, and patient-centered outcomes in healthcare and healthcare education. However, low methodological quality, study design limitations, and heterogeneity in the measurement of UT limit strong inferences about its effects, and addressing these problems is a critical need for future research.
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