Facework and uncertain reasoning in health communication

Objectives: Health care professionals often need to convey good and bad prospects to patients, and these news can be qualified by various uncertainty terms. Based on a sociolinguistic analysis of the way these uncertainty terms are used, we predicted that they would be interpreted differently by patients as a function of whether they qualified good news or bad news. Method: Two studies investigating causal inferences were conducted among a sample of French university students (Study 1, N= 50), and among a sample of Italian pregnant women (Study 2, N= 532). Results: Participants felt greater confidence in the conclusions they derived when the news were bad, as compared to the conclusions they derived when the news were good. Conclusion: The findings have implications for health care professionals who communicate good and bad prospects to patients, and who need to qualify the certainty of these prospects. Practice implications: Professionals should be aware that when the news are bad, any hedging term such as "possible" can be misunderstood as an attempt to sugar-coat the pill, and that this misinterpretation can lead patient to inferences that are not shared by the professional. © 2010 Elsevier Ireland Ltd.