Managing Uncertainty

Uncertainty is central to the experience of all sorts of illnesses; communication can be a means of responding to uncertainty and can also be a source of further uncertainty.  Dale Brashers was a dear friend and colleague and uncertainty management was one of our many shared interests.  My writing about uncertainty reflects my collaborations with him, as well as my earlier training in cultural communication.

Goldsmith, D. J. (2009).  Uncertainty and communication in couples coping with serious illness.  In T. Afifi, & W. Afifi (Eds.), Uncertainty and information regulation:  Theories and applications (pp. 203-225).  New York: Routledge.

This chapter explores how couples coping with serious illness manage uncertainty using the voices of couples coping with heart disease or cancer to give examples of theoretical issues. The chapter begins by discussing how couple interdependence creates distinctive coping demands, a phenomenon variously conceptualized as “relational,” “communal,” or “dyadic” coping. Then I discuss how these dyadic processes shape interrelated uncertainties about illness, identity, and relationships. Research on uncertainty management and dyadic coping strategies provide a basis for speculating how couples facing illness communicate. Finally, I suggest directions for future research. Throughout, I show how studying uncertainty in the couple-coping-with-illness context extends theory in two ways: (1) we consider not only individual but also dyadic uncertainty management, and (2) we find interrelationships among multiple types of uncertainty.

Brashers, D. E., Neidig, J. L., & Goldsmith, D. J. (2004).  Social support and the management of uncertainty for people living with HIV or AIDS.  Health Communication, 16, 305-331.

People with chronic and acute illnesses experience uncertainty about their prognoses, potential treatments, social relationships, and identity concerns. In a focus group study of people living with HIV or AIDS, we examined how social support may facilitate or interfere with the management of uncertainty about health, identity, and relationships. We found that support from others helps people with HIV or AIDS to manage uncertainty by (a) assisting with information seeking and avoiding, (b) providing instrumental support, (c) facilitating skill development, (d) giving acceptance or validation, (e) allowing ventilation, and (f) encouraging perspective shifts. Respondents also reported a variety of ways in which supportive others interfered with uncertainty management or in which seeking support imposed costs. Problems associated with social support and uncertainty management included a lack of coordination in uncertainty management assistance, the addition of relational uncertainty to illness uncertainty, and the burden of others’ uncertainty management. Our study reveals strategies respondents used to manage costs and complications of receiving support, including developing an active or self-advocating orientation, reframing supportive interactions, withdrawing from nonproductive social situations, selectively allowing others to be support persons, and maintaining boundaries.

Brashers, D. E., Goldsmith, D. J., & Hsieh, I. (2002).  Information seeking and avoiding in health contexts.  Human Communication Research, 28, 258-271.

Peers may be important sources of coping assistance, but their impact can be better understood if we examine their influence across various contexts. Although social support studies focused on people living with HIV have examined peer support in various contexts, they do not comprehensively account for situations in which peer support might be provided. The specific aims of this study are to (a) describe the various forms and functions of peer support for people living with HIV and (b) validate the Dennis (2003) concept analysis of peer support within health contexts. Results indicate that peer support is a potentially important adjunct to clinical care for enhancing coping skills, thereby improving the psychosocial functioning of people living with HIV. It is important to (a) assess patient access to peer support, (b) provide opportunities for peer support in the clinical setting, and (c) enhance disclosure and support-seeking skills to facilitate this benefit.

Goldsmith, D. J. (2001).  A normative approach to the study of uncertainty and communication.  Journal of Communication, 51, 514-533.

Uncertainty reduction theory (Berger & Calabrese, 1975) was formulated to explain relationships between the frequency of communication behaviors, level of uncertainty, and level of relational qualities. In this essay, I advocate attention to an alternative set of research questions addressed to the meanings and evaluations of uncertainty and communicative responses to uncertainty. This normative approach entails a shift in focus from measuring level of uncertainty to examining multiple and potentially conflicting meanings of uncertainty, a shift from measuring communication behaviors to evaluating communication practices, and a shift from predicting what people will do to predicting and explaining the effectiveness and appropriateness of what they do in response to uncertainty. Four case studies from various sociocultural contexts illustrate phenomena that are explained by a normative approach to uncertainty and communication.

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