Uncertainty in Health Information Behavior from the Perspective of Uncertainty Management Theory: A Scoping Review

Document Type : Original Article

Authors

1 School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran

2 Student, School of Health Management and Information Sciences, Iran University of Medical Sciences, Tehran, Iran.

3 Professor, Health Management and Economics Research Center, Health Management Research Institute, Iran University of Medical Sciences, Tehran, Iran.

10.22034/ijism.2026.2047759.1663
Abstract
Uncertainty is a common experience, especially in the health field. Individuals use many information behaviors to overcome uncertainty. Among the communication theories, the uncertainty management theory focuses more on information behavior. In this regard, relatively good studies have been conducted in the field of uncertainty management theory. The present study, by reviewing related studies, aims to identify the types and sources of uncertainty, the communication reactions of individuals to experienced uncertainty, the reasons for seeking or avoiding information, and the types of information sought or avoided. The research method of this study is a scoping review. After selecting the appropriate search strategy and inclusion and exclusion criteria, 53 articles from the studies extracted from MEDLINE/PubMed, Scopus, and ISI Web of Knowledge were selected for final review. The results showed that uncertainties in health information behavior occur at both individual and collective levels, and sources and types can be identified according to the context. Also, various strategies are used to deal with uncertainties at these two levels; the most common is seeking and avoiding information in different ways to reduce, increase, maintain, or adapt to uncertainty. In conclusion, this review provides a novel and comprehensive mapping of uncertainty in health information behavior. Unlike previous work, it explicitly delineates the complex reasons and methods underlying information seeking versus avoidance across diverse health contexts. This synthesis offers a foundational framework for developing targeted interventions to improve communication and support for individuals and families navigating health uncertainty.
 
 

Keywords

Subjects


Ahn, J. W. (2017). Structural equation modeling of cultural competence of nurses caring for foreign patients. Asian Nursing Research, 11(1), 65–73.  https://doi.org/10.1016/j.anr.2017.03.001
Arksey, and O'Malley, L. (2005). Scoping studies: towards a methodological framework. International Journal of Social Research Methodology, 8, 19–32. https://doi.org/10.1080/1364557032000119616
Anderson, T. D. (2006). Uncertainty in action: Observing information seeking within the creative processes of scholarly research. Information Research: An International Electronic Journal, 12(1), n1.‏ https://files.eric.ed.gov/fulltext/EJ1104687.pdf
Barbour, J. B., Rintamaki, L. S., Ramsey, J. A., & Brashers, D. E. (2012). Avoiding health information. Journal of Health Communication, 17(2), 212-229.‏ https://doi.org/10.1080/10810730.2011.585691
Basinger, E. D., Delaney, A. L., & Williams, C. (2023). Uncertainty management in online sexual health forums. Health Communication, 38(5), 875-884. https://doi.org/10.1080/10410236.2021.1980253
Bennett, K., Frisby, B. N., Young, L. E., & Murray, D. (2014). Vitamin D: An examination of physician and patient management of health and uncertainty. Qualitative Health Research, 24(3), 375–386. https://doi.org/10.1177/1049732314523681
Brashers, D. E. (2001). Communication and uncertainty management. Journal of Communication, 51(3), 477-497.‏ https://doi.org/10.1111/j.1460-2466.2001.tb02892.x
Brashers, D. E. (2007). A theory of communication and uncertainty management. In B. Whaley & W. Samter (Eds.), Explaining communication: Contemporary theories and exemplars. (pp. 2001–2218). Erlbaum. 
Brashers, D. E., & Babrow, A. S. (1996). Theorizing communication and health.‏ Communication Studies, 47(3), 243-251. https://doi.org/10.1080/10510979609368479
Campbell-Salome, G., & Barbour, J. B. (2022). Managing uncertainty for and with family: Communication strategies and motivations in familial uncertainty management for hereditary cancer. Qualitative Health Research, 32(8-9), 1230-1245. https://doi.org/10.1177/10497323221090191
Carcioppolo, N., Yang, F., & Yang, Q. (2016). Reducing, maintaining, or escalating uncertainty? The development and validation of four uncertainty preference scales related to cancer information seeking and avoidance. Journal of Health Communication, 21(9), 979-988.‏ https://doi.org/10.1080/10810730.2016.1184357
Chae J. (2016). Who avoids cancer information? Examining a psychological process leading to cancer information avoidance. Journal of Health Communication, 21(7), 837–844. https://doi.org/10.1080/10810730.2016.1177144
Chen, L. (2015). Deciding to institutionalize: Caregiving crisis, intergenerational communication, and uncertainty management for elders and their children in Shanghai. Journal of Gerontological Social Work, 58(2), 128-148.‏ https://doi.org/10.1080/01634372.2014.925026
Cooke-Jackson, A., Rubinsky, V., & Gunning, J. N. (2023). Wish I had known that before I started using it: Contraceptive messages and information seeking among young women. Health Communication, 38(4), 834–843. https://doi.org/10.1080/10410236.2021.1980249
Darnell, W. H., & Scott, A. M. (2023). Michelle P. Medicaid waivers: Exploring sources of uncertainty for parent caregivers of children with disabilities. Health Communication, 39(7), 1393–1403. https://doi.org/10.1080/10410236.2023.2214988
Dean M. (2016). "It's not if I get cancer, it's when I get cancer": BRCA-positive patients' (un)certain health experiences regarding hereditary breast and ovarian cancer risk. Social Science & Medicine, 163, 21–27. https://doi.org/10.1016/j.socscimed.2016.06.039
Delorme, D. E., & Huh, J. (2009). Seniors' uncertainty management of direct-to-consumer prescription drug advertising. Health Communication24(6), 494-503.‏ https://doi.org/10.1080/10410230903104277
Feltwell, A. K., & Rees, C. E. (2004). The information-seeking behaviours of partners of men with prostate cancer: A qualitative pilot study. Patient Education and Counseling, 54(2), 179–185. https://doi.org/10.1016/S0738-3991(03)00212-X
Fisher, C. L., Roccotagliata, T., Rising, C. J., Kissane, D. W., Glogowski, E. A., & Bylund, C. L. (2017). "I don't want to be an ostrich": Managing mothers' uncertainty during BRCA1/2 genetic counseling. Journal of Genetic Counseling, 26(3), 455–468. https://doi.org/10.1007/s10897-016-9998-x
Fisher, C. L., Wright, K. B., Hampton, C. N., Vasquez, T. S., Kastrinos, A., Applebaum, A. J., Sae-Hau. M., Weiss E. S., Lincoln, G.,  & Bylund, C. L. (2021). Blood cancer caregiving during COVID-19: Understanding caregivers' needs. Translational Behavioral Medicine, 11(5), 1187-1197.‏ https://doi.org/10.1093/tbm/ibab021
Fouché, M., Hartwig, L., & Pretorius, C. (2019). Management of uncertainty in the diagnosis communication of psychogenic nonepileptic seizures in a South African context. Epilepsy & Behavior, 98(Pt A), 45-52. https://doi.org/10.1016/j.yebeh.2019.06.009
Gameiro, S., Armstrong, K., Carluke, N., Baccino, G., Zegers-Hochschild, F., & Boivin, J. (2023). COVID-19-related uncertainty: Fertility staff experiences of its sources, processing, responses, and consequences. Human Reproduction, 38(2), 247-255.‏ https://doi.org/10.1093/humrep/deac262
Gasiorek, J., Fowler, C., & Giles, H. (2019). Communication and successful aging: Testing alternative conceptualizations of uncertainty. Communication Monographs, 86(2), 229-250.‏ https://doi.org/10.1080/03637751.2018.1538561
Heesen, C., Köpke, S., Solari, A., Geiger, F., & Kasper, J. (2013). Patient autonomy in multiple sclerosis: possible goals and assessment strategies. Journal of the Neurological Sciences, 331(1-2), 2-9.‏ https://doi.org/10.1016/j.jns.2013.02.018
Hughes, S. L., & Romo, L. K. (2020). An exploration of how individuals with an ostomy communicatively manage uncertainty. Health Communication, 35(3), 375-383.‏ https://doi.org/10.1080/10410236.2018.1563850
Jensen, J. D., & Hurley, R. J. (2012). Conflicting stories about public scientific controversies: Effects of news convergence and divergence on scientists' credibility. Public Understanding of Science (Bristol, England), 21(6), 689–704. https://doi.org/10.1177/0963662510387759
Kastrinos, A., Campbell-Salome, G., Shelton, S., Peterson, E. B., & Bylund, C. L. (2021). PGx in psychiatry: Patients’ knowledge, interest, and uncertainty management preferences in the context of pharmacogenomic testing. Patient Education and Counseling, 104(4), 732-738.‏ https://doi.org/10.1016/j.pec.2020.12.021
 
Kastrinos A., Salafia C., Gebert R. R., Mroz E. L., Fisher C. L., Applebaum A. J. (2025). Getting cancer Is "Just Bad Luck": Exploring bereaved emerging and young adults' cancer risk uncertainty after caring for a parent with Advanced Cancer. PsychoOncology. 34(5), e70161. https://doi.org/10.1002/pon.70161
Kerr, A. M., & Haas, S. M. (2014). Parental uncertainty in illness: Managing uncertainty surrounding an “orphan” illness. Journal of Pediatric Nursing, 29(5), 393–400. https://doi.org/10.1016/j.pedn.2014.01.008
Kerr, A. M., Rubinsky, V., & Duty, K. (2023a). Pediatricians' communication about medical uncertainty: Goal-oriented communication and uncertainty management. Health Communication, 38(7), 1454-1466. https://doi.org/10.1080/10410236.2021.2012896
Kerr, A. M., Spaeth, L. D., & Gerome, J. M. (2023b). Medical students’ stress and uncertainty during the COVID-19 pandemic. Health Communication, 38(10), 2247-2257.‏ https://doi.org/10.1080/10410236.2022.2062826
Kuang, k., & Gettings, p. E. (2021). Interactions among actual uncertainty, desired uncertainty, and uncertainty discrepancy on anxiety and information seeking. Journal of Health Communication, 26(2), 127-136. https://doi.org/10.1080/10810730.2021.1883774
Leverenz, A., & Hernandez, R. A. (2023). Uncertainty management strategies in communication about urinary tract infections. Qualitative Health Research, 33(4), 321-333. https://doi.org/10.1177/10497323231156370
Martin, A.J., Nejad, H., Colmar, S., & Liem, G.A.D. (2012). Adaptability: Conceptual and empirical perspectives on responses to change, novelty, and uncertainty. Australian Journal of Guidance and Counselling, 22, 58-81. https://doi.org/10.1017/jgc.2012.8
Matta, F. K., Scott, B. A., Guo, Z. A., & Matusik, J. G. (2020). Exchanging one uncertainty for another: Justice variability negates the benefits of justice. Journal of Applied Psychology, 105(1), 97–110. https://doi.org/10.1037/apl0000425
Miao, M., Dahm, M. R., Li, J., Thomas, J., & Georgiou, A. (2020). Managing uncertainty during the communication of diagnostic test information between patients and clinicians in Australian emergency care. Qualitative Health Research, 30(8), 1287-1300.‏ https://doi.org/10.1177/1049732320913037
Miller, L. E. (2014). Uncertainty management and information seeking in cancer survivorship. Health Communication, 29(3), 233-243.‏ https://doi.org/10.1080/10410236.2012.739949
Mishel, M. H., & Barron, C. R. (2012). Stress, uncertainty, and health. In V. H. Rice (Ed.) Handbook of stress, coping, and health: Implications for nursing research, theory, and practice. (2nd ed.) (pp. 510–533). Sage Publications.
Oprescu, F., Campo, S., Lowe, J., Andsager, J., & Morcuende, J. A. (2013a). Managing uncertainty in the context of clubfoot care: Exploring the value of uncertainty management theory and the sense of virtual community. The Iowa Orthopaedic Journal, 33, 142-148. PMCID: PMC3748870 
Oprescu, F., Campo, S., Lowe, J., Andsager, J., & Morcuende, J. A. (2013b). Online information exchanges for parents of children with a rare health condition: Key findings from an online support community. Journal of Medical Internet Research, 15(1), e16. https://doi.org/10.2196/jmir.2423
 
 
Perez, L., Romo, L. K., & Bell, T. (2019). Communicatively exploring uncertainty management of parents of children with type 1 diabetes. Health Communication, 34(9), 949-957. https://doi.org/10.1080/10410236.2018.1446249
Phillips C., Parkinson A., Namsrai T., Chalmers A., Dews C., Gregory D., Kelly E., Lowe C., Desborough J. (2024). Time to diagnosis for a rare disease: managing medical uncertainty. A qualitative study. Orphanet Journal of Rare Diseases. 19(1), 297. https://doi.org/10.1186/s13023-024-03319-2
Prince, A. G. (2021). Managing anxiety and uncertainty: applying anxiety/uncertainty management theory to university health professionals and students’ communication. Journal of Communication in Healthcare, 14(4), 293-302.‏ https://doi.org/10.1080/17538068.2021.1913946
Rains, S. A. (2014). Health information seeking and the World Wide Web: an uncertainty management perspective. Journal of Health Communication, 19(11), 1296-1307.‏ https://doi.org/10.1080/10810730.2013.872731
Rains, S. A., & Tukachinsky, R. (2015a). Uncertainty management theory proposes an examination of the relationships among uncertainty, appraisal, and information-seeking behaviorHealth Communication, 30(4), 339-349. https://doi.org/10.1080/10410236.2013.858285
Rains, S. A., & Tukachinsky, R. (2015b). Information seeking in uncertainty management theory: Exposure to information about medical uncertainty and information-processing orientation as predictors of uncertainty management success. Journal of Health Communication, 20(11), 1275-1286. https://doi.org/10.1080/10810730.2015.1018641
Rauscher, E. A., Dean, M., & Campbell-Salome, G. M. (2018). “I am uncertain about what my uncertainty even is”: Men’s uncertainty and information management of their BRCA-related cancer risks. Journal of Genetic Counseling, 27(6), 1417-1427.‏ https://doi.org/10.1007/s10897-018-0276-y
Rauscher, E. A., Dean, M., Campbell-Salome, G. M., & Barbour, J. B. (2019). “How do we rally around the one who was positive?” Familial uncertainty management in the context of men managing BRCA-related cancer risks. Social Science & Medicine, 242, 112592.‏ https://doi.org/10.1016/j.socscimed.2019.112592
Romo, L. K., & Luurs, G. (2021). How college students communicate about uncertainty regarding university health services. Health Communication, 36(8), 1009-1017.‏ https://doi.org/10.1080/10410236.2020.1731780
Romo, L. K., Thompson, C. M., & Ben-Israel, P. (2022). An examination of how people appraise and manage health-related financial uncertainty. Health Communication, 37(8), 935–943. https://doi.org/10.1080/10410236.2021.1876813
Sairanen, A., & Savolainen, R. (2010). Avoiding health information in the context of uncertainty management.‏ Information Research, 15(4), 443-458.       http://informationr.net/ir/15-4/paper443.html
Senteio, C. R., & Ackerman, M. K. (2022). Count me out: Perceptions of black patients who are on dialysis but who are not on a transplant waitlist. Health Communication, 37(9), 1167-1179.‏ https://doi.org/10.1080/10410236.2021.1940017
Tetteh, D. A., & Akhther, N. (2021). Openness and topic avoidance in interpersonal communication about ovarian cancer: An uncertainty management perspective. Qualitative Research, 5, 9376.‏ https://doi.org/10.4081/qrmh.2021.9376
Thau, S., Aquino, K., & Wittek, R. (2007). An extension of uncertainty management theory to the self: The relationship between justice, social comparison orientation, and antisocial work behaviors. Journal of Applied Psychology, 92(1), 250-258.‏ https://doi.org/10.1037/0021-9010.92.1.250
Thompson C. M., Pulido M. D., Gangidi S., Arnold P. (2024). How Chronic Pain Patients' and Physicians' Communication Influences Patients' Uncertainty: A Pre- and Post-Consultation Study. Journal of Health Communication. 29(5), 357-370. https://doi.org/10.1080/10810730.2024.2352556
Thompson, C. M., Rhidenour, K. B., Blackburn, K. G., Barrett, A. K., & Babu, S. (2022). Using crowdsourced medicine to manage uncertainty on Reddit: The case of COVID-19 long-haulers. Patient Education and Counseling, 105(2), 322-330.‏ https://doi.org/10.1016/j.pec.2021.07.011
Thompson, C. M., Romo, L. K., Pulido, M. D., Liao, D., Kriss, L. A., & Babu, S. (2023). Denying and accepting a family member's illness: Uncertainty management as a process. Health Communication, 38(3), 594-607.‏ https://doi.org/10.1080/10410236.2021.1964713
Volkman, J. E., & Silk, K. J. (2008). Adolescent females and their mothers: examining perceptions of the environment and breast cancer. Journal of Health Psychology, 13(8), 1180–1189. https://doi.org/10.1177/1359105308095972
Wang, X., & Zhou, F. (2021). Managing the uncertainties inherent in prohibitive voice: How leadership interacts with employee political skill. Frontiers in Psychology, 12, 702964. https://doi.org/10.3389/fpsyg.2021.702964
Watermeyer, J., Kanji, A., & Brom, L. (2020). "What's going on with my ears?": Some reflections on managing uncertainty in the audiology consultation. American Journal of Audiology, 29(3), 504–512. https://doi.org/10.1044/2020_AJA-19-00116
Wu, T. Y., Chung, P. F., Liao, H. Y., Hu, P. Y., & Yeh, Y. J. (2019). Role ambiguity and economic hardship as the moderators of the relation between abusive supervision and job burnout: An Application of uncertainty management theory. The Journal of General Psychology, 146(4), 365-390. https://doi.org/10.1080/00221309.2019.1585323
Zimbres, T. M., Bell, R. A., Miller, L. M. S., & Zhang, J. (2021). When media health stories conflict: Test of the contradictory health information processing (CHIP) model. Journal of Health Communication, 26(7), 460-472.‏  
Volume 24, Issue 1
Winter 2026
Pages 111-132

  • Receive Date 26 December 2024
  • Accept Date 28 January 2026