Patient-centered communication, trust, uncertainty, and informational support: Testing the communication pathways model in OB/GYN care.

Abstract

While healthcare providers' use of patient-centered communication (PCC) is associated with positive outcomes like perceptions of trust and social support for patients, uncertainty may affect this relationship, especially during prenatal care. The purpose of this study, drawing upon the pathways from communication to outcomes model, was to determine whether trust mediates the relationship between PCC and informational support, and whether uncertainty moderates the relationship between PCC and informational support, PCC and trust, and trust and informational support among pregnant patients when communicating with their obstetrician/gynecologists (OB/GYNs). The study consists of a cross-sectional, correlational design. U.S. pregnant women (N = 549) were recruited via Prolific to complete an online survey inquiring about communication with and perceptions of their OB/GYNs during prenatal visits. Results were analyzed using a moderated mediation model. Patient-centered communication was positively associated with trust. Trust was positively associated with informational support and significantly mediated the relationship between PCC and informational support at low and moderate uncertainty levels. Uncertainty significantly moderated all three relationships. At lower levels of uncertainty, the relationships between PCC and trust, and trust and informational support were stronger than at higher levels of uncertainty; however, the relationship between PCC and informational support was stronger at higher levels of uncertainty. The findings indicated trust mediated the relationship between PCC and informational support. The results also indicated that pregnancy-related uncertainty functioned as a boundary condition, moderating the strength of the associations between PCC and trust and between trust and informational support, underscoring the importance of considering uncertainty in prenatal communication. OB/GYNs can engage in PCC behaviors like explaining information in a clear manner and attending to patient emotions. They can also complete communication skills training in PCC, and consider the uncertainty levels of their patients.