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Original Articles
- Uncertainty in Patients Newly Diagnosed with Atrial Fibrillation
- Younhee Kang
- Journal of Korean Academy of Nursing 2002;32(7):960-966. Published online March 29, 2017
- DOI: https://doi.org/10.4040/jkan.2002.32.7.960
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Abstract
PDF PURPOSE OF THE STUDY: Atrial fibrillation is the most common sustained cardiac rhythm disturbance encountered in clinical practice. In contrast to its high prevalence and the associated high number of hospital admissions, there is a paucity of published studies that have evaluated the perspective of patients with atrial fibrillation or patients' perceptions or responses to diagnosis, treatment, or prognosis of atrial fibrillation in health care literature and clinical studies. This study aimed to explore uncertainty in diagnosis, treatment, and prognosis of atrial fibrillation.
METHODS
This study employed a descriptive cross-sectional survey design using a face-to-face interview method to explore uncertainty. Patients with atrial fibrillation confirmed by 12-lead ECG were interviewed. Uncertainty was measured by the Mishel Uncertainty in Illness Scale-Community Form (MUIS-C), and the data collected were analyzed by the Statistical Package for Social Science software program.
RESULTS
A total of 81 subjects were included in this study and their mean score of uncertainty was 62.60 with the standard deviation of 10.81. Uncertainty in patients with atrial fibrillation was higher than that reported in other disease populations such as bowel resection surgery, breast cancer, myocardial infarction, and so forth. However, it was lower than the level of uncertainty in patients with cardiac arrest and HIV disease.
CONCLUSION
From the findings of the present study, it was demonstrated that uncertainty existed in patients with atrial fibrillation, and this was considered to be part of patients' responses to atrial fibrillation. In terms of nursing practice and nursing research, uncertainty was explored and described as one of the most relevant phenomena in patients newly diagnosed with atrial fibrillation.
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- Testing the Mediating Effect of Appraisal in the Model of Uncertainty in Illness study
- Younhee Kang
- Journal of Korean Academy of Nursing 2003;33(8):1127-1134. Published online March 28, 2017
- DOI: https://doi.org/10.4040/jkan.2003.33.8.1127
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Abstract
PDF
Background Although there have been a great number of research studies based on the model of uncertainty in illness, few studies have considered the appraisal portion of model.
Purpose The purpose of this study was to test the mediating effect of appraisal in the model of uncertainty in illness. Additionally, this study aimed to examine the relationships among uncertainty, symptom severity, appraisal, and anxiety in patients newly diagnosed with atrial fibrillation.
Methods This study employed a descriptive correlational and cross-sectional survey design using a face-to-face interview method. Patients diagnosed with atrial fibrillation within the previous 6 months prior to data collection were interviewed by Mishel Uncertainty in Illness Scale-Community Form, appraisal scale, Symptom Checklist-Severity V.3, and State Anxiety Inventory.
Results A total of 81 patients with atrial fibrillation were recruited from two large urban medical centers in Cleveland, Ohio, U.S.A.. Symptom severity was the significant variable in explaining uncertainty (β=0.34). Individuals with greater symptom severity perceived more uncertainty. Uncertainty was appraised as a danger rather than opportunity, and those with greater uncertainty appraised a greater danger (p<.01). While the appraisal of opportunity had the negative relationship with anxiety (r=-0.25), the appraisal of danger was positively associated with anxiety (r=0.78). The measure of goodness of fit (Q) of the model was .7863, and the significant test (X2) for the Q was statistically significant (df =3, p<.001). Accordingly, the overall mediating model of uncertainty in illness was proven not to be fit to the empirical data of patients with atrial fibrillation. Consequently, the mediating effect of appraisal was not supported by the empirical data of this study.
Conclusion The findings of this study were discussed in terms of their relevance compared with those of previous studies or theoretical framework and the plausible explanations on study findings. Lastly, in order to expand the present body of knowledge on uncertainty in illness model, recommendations for the future nursing studies were included.
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