Improving Communication with Chronically Ill Patients: Exploring Relationships among Uncertainty, Hope, Trust, and Perceived Healthcare Provider Empathy

Theoretical Background and research questions/hypothesis: Uncertainty Management Theory (UMT) posits that discomfort arises when people are unable to confidently predict what is happening to them and around them. Effective communication is a mechanism through which uncertainty and resulting anxiety can be reduced. In this study, we look for relationships between uncertainty management skills and other communicative factors pertaining to chronically ill patients. Those factors are patients’ 1) hope regarding their health condition, 2) emotional health, 3) trust in their healthcare providers, and 4) perceptions of their providers’ empathy toward them.

Methods: A survey was constructed to measure respondents’ uncertainty management skill, hope, trust in healthcare providers, and perceived provider empathy, and IRB approval was granted for the study. The instrument was pre-tested on a group of 75 college students and found to be reliable for each of the variables using Cronbach’s alpha. Fifty chronically ill patients were then surveyed at a large hospital in a Southern state. Again, Cronbach’s alpha was used to measure reliability for each variable. This time, one variable--emotional health--proved to be unreliable in the clinical setting. Pearson’s correlation was used to ascertain relationships among all remaining variables.

Results: Positive correlations were found between uncertainty management skills and hope, on one hand, and with perceived provider empathy, on the other. A third positive correlation occurred between patient trust in providers and perceived provider empathy.

Conclusions: Patients’ sense of hopefulness and their belief in healthcare providers’ empathy toward them are important factors in building patients’ skills sets toward reducing anxiety. Further, patients' belief in providers’ empathy correlates with the trust that they feel toward their providers.

Implications for research and/or practice: Reduction of uncertainty via effective communication is an important step in managing stress among chronically ill patients. Healthcare providers can facilitate anxiety reduction by building trust between themselves and their patients. Trust, in turn, will help patients feel confident in providers’ ability to empathize. Taking the findings a step further, a combination of hope- and empathy-building communicative strategies can be a productive means toward reducing angst associated with patient uncertainty. Specific suggestions are provided.