فهرست نشریات علمی دسترسی آزاد ایران

BACKGROUND: Clinical decision‑making is not only stressful to physicians, but also to patients andeven their companions. Thus, managing uncertainty in clinical decision‑making is essential whichrequires knowing its origins. Therefore, this study aimed to understand determinants of uncertaintyin clinical decision‑making from the perspective of clinical physicians.MATERIALS AND METHODS: This is a qualitative study which is done during October to November2020. An in‑depth interview is performed with 24 specialists of clinical groups including obstetrics,surgery, internal medicine, and pediatrics, working in teaching hospitals affiliated to Iran Universityof Medical Sciences. All the interviews were recorded, transcribed and analyzed according to thesteps suggested by Graneheim and Lundman. The interviews were analyzed through comparativemethod. Then, the interviewer created initial codes, categories, and key concepts and sent them tofourteen physicians for member check.RESULTS: According to the participants’ view, determinants of uncertainty in clinical decision‑makingconsisted of three themes: individual determinants, dynamics of medical sciences, and diagnosticand instrumental constraint. Individual determinants can be related to the physician or patient. Thedynamics of medical sciences could be explained in two categories: variation of medical science andcomplexity. Diagnostic and instrumental constraint category could be also explained in subcategoriessuch as lack of efficient diagnostic tests and unknown etiology.CONCLUSION: To curb uncertainty, the more accessible way is considering interventional programswith a focus on individual determinants related to physicians, such as strengthening doctor–patientrelationships, and considering related mandatory retraining courses to reduce insufficient knowledgeof physicians.