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Objective: Physicians 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.Methods: In 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.Results: Non-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.Conclusion: Non-verbal communication of uncertainty by oncologists may affect patient trust and intention to seek a second-opinion more than verbal communication.Practice Implications: Further research to understand and improve oncologists' non-verbal uncertainty behavior is warranted. [ABSTRACT FROM AUTHOR]

Objectives: In health communication research using video vignettes, it is important to assess viewers' engagement. Engagement scores can indicate ecological validity of the design, and help distinguish between different engagement types. Therefore, we aimed to develop and validate a scale assessing viewers' engagement with video vignettes.Methods: Based on an existing question set, the 15-item, five-dimensional Video Engagement Scale (VES) was developed. The VES was validated in two video-vignettes studies to investigate patient-physician communication. In addition to engagement, we assessed its presumed correlates, e.g., perceived realism of the video and identification with the patient.Results: Internal consistency and test-retest reliability were adequate in both studies (N=181 and N=228). Positive correlations between the VES and perceived realism of the video, credibility of and identification with the patient suggested good content validity. Confirmatory factor analysis suggested a four-dimensional model fit, largely resembling our hypothesized model.Conclusions: The VES reliably and validly measures viewers' engagement in health communication research using video vignettes. It can be employed to assess ecological validity of this design. Further testing of the scale is needed to more solidly establish its dimensionality.Practice Implications: We recommend that researchers use the VES, to ensure ecological validity of future video-vignettes studies. [ABSTRACT FROM AUTHOR]

Abstract: Objective: Cancer patients need to trust their oncologist. How the oncologist communicates probably contributes to patients' trust. Yet, patient characteristics such as their attachment style and health locus of control may influence how such communication is perceived. We examined how these personality characteristics influence trust as well as moderate the relation between oncologist communication and trust. Methods: Eight videotaped scenarios of an oncologic consultation were created. Oncologist communication was systematically varied regarding their expressed competence, honesty and caring. Cancer patients (n =345) were randomly assigned to view the videos and report their trust in the observed oncologist. Patients' self-reported attachment style, health locus of control and trust in their own oncologist were assessed. Results: Patients with a stronger external health locus of control trusted the observed oncologist more (p <.001). Neither attachment avoidance nor attachment anxiety was related to trust in the observed oncologist. However, attachment avoidance moderated the positive effect of the oncologists' communication of caring and honesty on trust: avoidant attachment significantly diminished the effect (p <.011 and p <.044, respectively). High attachment avoidance (p =.003) and attachment anxiety (p <.001) were related to weaker trust in patients' own oncologist. Discussion: Patients' attachment avoidance may hamper their trust in their own, but not necessarily in a newly observed, oncologist. As expected, patients' attachment style influences how oncologist communication influences trust, underscoring the importance of oncologists tailoring their communication to individual patients. We confirmed observational findings that patients convinced that others control their health trust their oncologist more than others. [Copyright &y& Elsevier]