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Uncertainty in Illness

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Uncertainty in Illness
Introduction Uncertainty in illness is present for both acute and chronic illnesses and can be described as a cognitive stressor, a sense of loss of control, and a perceptual state of doubt which is dynamic in nature. Illness uncertainty can be associated with poor adjustment, but often needs to be evaluated as a threat to have its deleterious effect. For example, illness uncertainty in pain populations is related to increased sensitivity to pain and reduction in tolerance of painful stimuli. Illness uncertainty can result in maladaptive coping, higher psychological distress, and reduced quality of life. Uncertainty can’t be categorized as a good or bad state. It mainly depends on the situations that surround the uncertainty. It can be defined as the inability to understand the meaning of a situation or event and it can develop if the patient doesn’t completely comprehend the total magnitude of the state of his or her illness. The purpose of this paper is to explore the concept of uncertainty in illness and to review three nursing research studies to explain this concept in more detail. Concept- Uncertainty in Illness Nursing interest in the uncertainty associated with life-threatening diseases and chronic illnesses and their treatment technology is growing. Nurse investigators have tried to research variables that precede and influence this uncertainty, as well as how persons evaluate, cope with, and adjust to uncertainty. Mishel has extensively explored the concept of uncertainty in illness since the early1980s. She defines it as “the inability to determine the meaning of illness related events. It is the cognitive state created when the person cannot adequately structure or categorize an event because of the lack of sufficient cues" (Mishel, 1988). The family’s adaptation and coping strategies may prove to be inadequate in managing uncertainty surrounding illness conditions, which continues beyond the


References: Bailey, D., Jr., Wallace, M. & Latini, D. (2011). Measuring illness uncertainty in men undergoing active surveillance for prostate cancer. Applied Nursing Research, 24, 193–199. Carroll, S. & Arthur, H. (2010). A comparative study of uncertainty, optimism and anxiety in patients receiving their first implantable defibrillator for primary or secondary prevention of sudden cardiac death. International Journal of Nursing Studies, 47, 836–845. Dale, E., Hsieh, L. & Neidig, N. Managing Uncertainty about Illness: Health Care Providers as Credible Authorities, 221-239. Lin, L., Yeh, C. & Mishel, M. (2010). Evaluation of a conceptual model based on Mishel’s theories of uncertainty in illness in a sample of Taiwanese parents of children with cancer: A cross-sectional questionnaire survey. International Journal of Nursing Studies, 47, 1510–1524. Mishel, M. (1981). The measurement of uncertainty in illness. Nursing Research, 30 (5), 258–263. Mishel, M. (1988). Uncertainty in illness. Journal of Nursing Scholarship, 20 (40), 225–232. Wineman, M., Schwetz, M., Goodkin, E. & Rudick, A. (1996).Relationships among illness uncertainty, stress, coping and emotional well-being at entry into a clinical drug trial. Applied Nursing Research, 9(2), 53–60.

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