Abstract: Women’s Uncertainty Management Strategies in Communication about Urinary Tract Infections (UTIs)

◆ Alaina Leverenz, University of Missouri

◆ Rachael Hernandez, University of Missouri

Urinary Tract Infections (UTIs) are responsible for over 8 million doctor’s office visits a year (Tabibian et al., 2008), and women are 20 times more likely than men to be diagnosed with a UTI (Foxman, 2002). UTIs are painful and can lead to serious complications, and yet the etiology, symptoms, treatment and prevention of UTIs is often uncertain (Minardi, 2011). Moreover, little is known about how women manage this uncertainty about UTIs. Grounded in uncertainty management theory (UMT; Brashers, 2001), this study explored how individuals with female anatomy manage uncertainty surrounding UTIs. Iterative analysis (Tracy, 2013) was employed using UMT to analyze qualitative interview data (n = 21) with participants ranging in age from 20-63 (M = 32.4, SD = 11.4). Participants overwhelmingly sought to reduce and maintain uncertainty and did not seek to increase uncertainty. Strategies of eliciting social support, talking to health care providers, and using the internet to gather information emerged as salient themes. Participants solicited informational support from female family members and close friends in order to reduce uncertainty about the symptoms, treatment, and prevention of UTIs. Communicating with women as opposed to men was seen to reduce uncertainty regarding a confidant’s reaction to their disclosure about a UTI. Talking to heath care providers was a dominant strategy to reduce uncertainty about the diagnosis and treatment of their symptoms. However, although talking to health care providers was named as a strategy to manage uncertainty, these interactions inadvertently increased uncertainty as well. Providers were said to provide little information about UTIs, and often simply provided diagnostic tests and antibiotics without any counseling about the causes or prevention of UTIs. As a result, some participants gathered online information prior to communication with a clinician in order to reduce uncertainty about the type and quality of care they will receive. Participants also engaged in deception to reduce uncertainty about how their providers would respond to their pain and their illness. This uncertainty was borne of prior experiences of being disbelieved or denied care. In anticipation of- or reaction to- provider denial of care, participants employed strategies like omission, exaggeration, or deception. Finally, metaphor use was an uncertainty appraisal strategy (e.g., uncertainty as positive, negative, or neutral). A metaphor of UTIs as a “journey” were leveraged a dialogical to neutralize the negative experience of the uncertainties about UTI treatment and prevention, and project hope that chronic UTIs would not plague them in the future. Implications for these findings include guidelines and support for patient and provider communication, partner communication about UTIs, as well as deeper nuances and development for UMT.