Exploring preferences for the communication of uncertainty in Clinically Isolated Syndrome

Background: There is inherent uncertainty with a diagnosis of Clinically Isolated Syndrome (CIS), which can result in psychological distress for patients. This uncertainty and distress can be compounded by the way clinicians communicate the diagnosis. This study explored preferences for the communic...

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Main Author: Crouch, Millie
Format: Thesis (University of Nottingham only)
Language:English
Published: 2024
Subjects:
Online Access:https://eprints.nottingham.ac.uk/78547/
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author Crouch, Millie
author_facet Crouch, Millie
author_sort Crouch, Millie
building Nottingham Research Data Repository
collection Online Access
description Background: There is inherent uncertainty with a diagnosis of Clinically Isolated Syndrome (CIS), which can result in psychological distress for patients. This uncertainty and distress can be compounded by the way clinicians communicate the diagnosis. This study explored preferences for the communication of uncertainty in CIS, from the perspective of people with CIS and their spouses. Methods: Semi-structured interviews and one focus group were completed with 11 individuals with a diagnosis of CIS and two spouses. Simulations of consultation sessions between patients with suspected CIS and neurologists formed the basis of discussions. Data were analysed using inductive-deductive thematic analysis. Results: Four themes were generated from the analysis and are organised into a preferred order of conversation outlined by participants. Creating a relationship where patients feel cared for provides the foundation for the delivery of a CIS diagnosis and its uncertainties. Neurologists can help patients process the uncertain diagnosis by helping CIS to feel more tangible and concrete by naming the diagnosis and providing a clear explanation of CIS supported by visual evidence (e.g., scan results). When introducing multiple sclerosis as a potential prognosis, neurologists should preserve hope whilst communicating this reality. Neurologists can help patients feel more in control of future uncertainty by presenting a clear plan with access to support. Conclusions: Our findings identify preferences for how people with CIS and their spouses would like uncertainty to be communicated that can help to reduce patient distress, which can inform neurologists in their clinical practice.
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spelling nottingham-785472025-02-28T15:21:25Z https://eprints.nottingham.ac.uk/78547/ Exploring preferences for the communication of uncertainty in Clinically Isolated Syndrome Crouch, Millie Background: There is inherent uncertainty with a diagnosis of Clinically Isolated Syndrome (CIS), which can result in psychological distress for patients. This uncertainty and distress can be compounded by the way clinicians communicate the diagnosis. This study explored preferences for the communication of uncertainty in CIS, from the perspective of people with CIS and their spouses. Methods: Semi-structured interviews and one focus group were completed with 11 individuals with a diagnosis of CIS and two spouses. Simulations of consultation sessions between patients with suspected CIS and neurologists formed the basis of discussions. Data were analysed using inductive-deductive thematic analysis. Results: Four themes were generated from the analysis and are organised into a preferred order of conversation outlined by participants. Creating a relationship where patients feel cared for provides the foundation for the delivery of a CIS diagnosis and its uncertainties. Neurologists can help patients process the uncertain diagnosis by helping CIS to feel more tangible and concrete by naming the diagnosis and providing a clear explanation of CIS supported by visual evidence (e.g., scan results). When introducing multiple sclerosis as a potential prognosis, neurologists should preserve hope whilst communicating this reality. Neurologists can help patients feel more in control of future uncertainty by presenting a clear plan with access to support. Conclusions: Our findings identify preferences for how people with CIS and their spouses would like uncertainty to be communicated that can help to reduce patient distress, which can inform neurologists in their clinical practice. 2024-12-11 Thesis (University of Nottingham only) NonPeerReviewed application/pdf en arr https://eprints.nottingham.ac.uk/78547/1/Crouch%20Millie%204341364%20Corrections.pdf Crouch, Millie (2024) Exploring preferences for the communication of uncertainty in Clinically Isolated Syndrome. DClinPsy thesis, University of Nottingham. Clinically Isolated Syndrome CIS uncertainty qualitative simulation
spellingShingle Clinically Isolated Syndrome
CIS
uncertainty
qualitative
simulation
Crouch, Millie
Exploring preferences for the communication of uncertainty in Clinically Isolated Syndrome
title Exploring preferences for the communication of uncertainty in Clinically Isolated Syndrome
title_full Exploring preferences for the communication of uncertainty in Clinically Isolated Syndrome
title_fullStr Exploring preferences for the communication of uncertainty in Clinically Isolated Syndrome
title_full_unstemmed Exploring preferences for the communication of uncertainty in Clinically Isolated Syndrome
title_short Exploring preferences for the communication of uncertainty in Clinically Isolated Syndrome
title_sort exploring preferences for the communication of uncertainty in clinically isolated syndrome
topic Clinically Isolated Syndrome
CIS
uncertainty
qualitative
simulation
url https://eprints.nottingham.ac.uk/78547/