Medication non-adherence in the context of situated uncertainty: Moving beyond simple, dichotomous approaches

Lau, Sofie Rosenlund; Kriegbaum, Margit

doi:10.1016/j.sapharm.2017.09.003

Cited by 3 publications

(17 citation statements)

References 31 publications

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Section: Resultsmentioning

confidence: 99%

“…Sources of uncertainty were described in 20 conceptual models 8,14,22,26,31,41‐47,50‐56,58 and are summarized in Appendix S1. Knowledge was described as a source of uncertainty in 18 models 8,14,22,26,31,41,43‐47,50‐52,54‐56,58 . Knowledge as a source of uncertainty was represented by three categories: lack of knowledge, the nature of knowledge, and application of knowledge.…”

Section: Resultsmentioning

confidence: 99%

“…Knowledge as a source of uncertainty was represented by three categories: lack of knowledge, the nature of knowledge, and application of knowledge. Uncertainty derived from a lack of knowledge was identified in 16 models 8,14,22,26,43‐47,50‐52,54‐56,58 . The nature of knowledge was a source of uncertainty in five models 22,26,31,41,55 .…”

Section: Resultsmentioning

confidence: 99%

“…For example, a doctor may be uncertain about tailoring management for a patient 43 or in how to apply abstract knowledge to clinical scenarios 8,54 . Relationships were described as a source of uncertainty in 13 models 8,14,31,43,45‐47,51‐54,56,58 . This uncertainty can stem from communicational issues between a doctor and patient 54 or interactions with other healthcare professionals 52 .…”

Section: Resultsmentioning

confidence: 99%

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Towards a new understanding of uncertainty in medical education

Lee

Hall

Anakin

et al. 2020

Evaluation Clinical Practice

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Rationale, aims, and objectives Uncertainty is a complex and constant phenomenon in clinical practice. How medical students recognize and respond to uncertainty impacts on their well‐being, career choices, and attitudes towards patients. It has been suggested that curricula should do more to prepare medical students for an uncertain world. In order to teach medical students about uncertainty, we need to understand how uncertainty has been conceptualized in the literature to date. The aim of this article is to explore existing models of uncertainty and to develop a framework of clinical uncertainty to aid medical education. Method A scoping literature review was performed to identify conceptual models of uncertainty in healthcare. Content and inductive analyses were performed to explore three dimensions of clinical uncertainty: sources of uncertainty, subjective influencers and responses to uncertainty. Results Nine hundred one references were identified using our search strategy, of which, 24 met our inclusion criteria. It was possible to classify these conceptual models using one or more of three dimensions of uncertainty; sources, subjective influencers, and responses. Exploration and further classification of these dimensions led to the development of a framework of uncertainty for medical education. Conclusion The developed framework of clinical uncertainty highlights sources, subjective influencers, responses to uncertainty, and the dynamic relationship among these elements. Our framework illustrates the different aspects of knowledge as a source of uncertainty and how to distinguish between those aspects. Our framework highlights the complexity of sources of uncertainty, especially when including uncertainty arising from relationships and systems. These sources can occur in combination. Our framework is also novel in how it describes the impact of influencers such as personal characteristics, experience, and affect on perceptions of and responses to uncertainty. This framework can be used by educators and curricula developers to help understand and teach about clinical uncertainty.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

See 2 more Smart Citations

Towards a new understanding of uncertainty in medical education

Lee

Hall

Anakin

et al. 2020

Evaluation Clinical Practice

View full text Add to dashboard Cite

show abstract

“…These explanations generally centre on the way patients understand the medication's purpose. Lau and Kriegbaum (2018), for example, examine patients' perceptions of "the uncertainties related to statins" in their study of non-adherence. The authors describe the distributed and sociallysituated ways in which patients collect information and build knowledge, challenging the assumption that the way to improve statin adherence is to get clinicians to explain statins' benefits better.…”

Section: Introductionmentioning

confidence: 99%