This study aimed to examine the effects of a mobile navigation program on uncertainty, resilience, and growth through uncertainty in colorectal cancer patients.
To verify the effectiveness of the mobile navigation program, 61 participants diagnosed with colorectal cancer undergoing surgery were selected. A nonequivalent control group nonsynchronized design was used to evaluate the program. Uncertainty was measured using the Korean version of the Uncertainty in Illness Scale, resilience was measured using the Korean version of the Connor-Davidson Resilience Scale, and growth through uncertainty was measured using the Growth through Uncertainty Scale.
Compared with the control group, patients in the mobile navigation program group showed significant differences in scores for uncertainty (F=7.22,
These results suggest that the mobile navigation program has positive effects on decreasing uncertainty and increasing resilience among colorectal cancer patients. The mobile navigation program could play a significant role in assisting colorectal cancer patients in regard to the continuity and usability of the program.
This study aimed to test the mediating effect of uncertainty appraisal and coping style in the relation between uncertainty and anxiety in hospitalized pregnant women diagnosed with preterm labor.
The participants were 105 pregnant women diagnosed with preterm labor in hospitals in Korea. Data were collected from July to October 2017. The measurements included the Uncertainty in Illness Scale, Uncertainty Appraisal Scale, Coping Style Scale, and State Anxiety Inventory. Data were analyzed using descriptive statistics, an independent t-test, correlation, and multiple regression following the Baron and Kenny method and Sobel test for mediation.
The mean score for anxiety was 2.29 out of 4.00 points and for uncertainty it was 2.46 out of 5.00 points. There were significant correlations among uncertainty, uncertainty danger appraisal, uncertainty opportunity appraisal, problem-focused coping, emotion-focused coping, and anxiety. Uncertainty danger appraisal (β=.64,
Nursing intervention programs focusing on managing uncertainty appraisal and improving emotion-focused coping are highly recommended to decrease anxiety in hospitalized pregnant women diagnosed with preterm labor.
The purpose of this study was to examine the mediating effect of marital intimacy on the impact of uncertainty on the quality of life (QoL) of young breast cancer patients.
This study used a pathway analysis with 154 young breast cancer cases in their early diagnosis stage at a medical center in Korea. Data were collected from November 2016 to February 2017 and analyzed using correlation analysis and pathway analysis.
Uncertainty, marital intimacy, and 4 sub-scales of QoL showed a significant correlation. Marital intimacy was directly affected by uncertainty (b=-.39,
Effects of uncertainty on QoL was mediated by marital intimacy of young breast cancer patients in their early diagnosis stage. It suggests that marital intimacy needs to be considered in providing nursing intervention for young breast cancer patients.
This study was conducted to develop an Empowerment Education Program (EEP) for kidney transplant patients and to test the program's effects on uncertainty, self-care ability, and compliance.
The research was conducted using a nonequivalent control group with a pretest-posttest design. The participants were 53 outpatients (experimental group: 25, control group: 28) who were receiving hospital treatment after kidney transplants. After the pre-test, patients in the experimental group underwent a weekly EEP for six weeks. The post-test was conducted immediately after, and four weeks after the program's completion in the same manner as the pre-test. For the control group, we conducted a post-test six and ten weeks after the pre-test, without and program intervention. A repeated measure ANOVA was performed to compare the change scores on main outcomes.
Uncertainty was significantly lower in the experimental group than in the control group, both immediately after (t=-3.84,
Kidney transplant patients who underwent an EEP showed a decrease in uncertainty and an improvement in self-care ability and compliance. Thus, our findings confirmed that an EEP can be an independent intervention method for improving and maintaining the health of kidney transplant patients.
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.
The purpose of this study was to investigate the effects of coping mechanisms on uncertainty and depression. The subjects were 71 cancer patients selected from Junbook National University Hospital, and the data collection period was from June 21 to October 19 of 2000. Uncertainty was measured by using Mishel's Uncertainty Scale, problem- focused coping, and emotional-focused coping. The data was collected by a questionnaire developed by Lee (1984), and then depression measured by using Beck's depression scale. Data was analyzed with SPSS/WIN 7.5 program by Pearson Correlation Coefficients, and Path analysis. The results were as follows : 1. The mean uncertainty score was 59.17, the mean problem-focused coping score was 48.78, the mean emotional-focused coping score was 42.52. 2. The mean depression score was 15.77. 3. Uncertainty in illness was significantly related to depression (p=0.003) and emotional-focused coping (p=0.028), but uncertainty was not associated with coping mechanisms. 4. When analyzed multiple regression between uncertainty, problem-focused coping, emotional- focused coping, and depression, more specifically emotional-focused coping showed a stronger association with depression than problem-focused coping. 5. Depression was highly correlated with economic status (p=0.015), educational background (p=0.005), duration of disease (p=0.045). 6. Problem-focused coping and emotional-focused coping appeared to function as moderators instead mediators on the relation between uncertainty and depression. In addition, as a whole, uncertainty showed a significant moderating effect on depression, while problem-focused coping did on depression. Finally, limitation of present findings were discussed and implications for future studies are suggested.
The purpose of this study was to provide basic information for developing a nursing intervention that helps patients learn how to acquire coping to reduce post operation uncertainty and anxiety by investigating the level of uncertainty and anxiety experienced by mastectomy patients. The subjects were 134 patients selected from St. Mary's Kangnam and St. Mary's hospital, and the data collection period was from October to December of 1998. Uncertainty was measured by using Mishel Uncertainty in Illness Scale (MUIS), anxiety measured by using State-Trait Anxiety Inventory(STAI), and coping by using a questionnaire developed by Kim & Yoo (1996). Data were analyzed with SAS program by t-test, ANOVA, Duncan's multiple range test, Pearson correlation coefficients, and stepwise multiple regression. The results were as follows: 1. The mean uncertainty score was 57.6. The results of the correlation between the compliance of medical regimen and demographic characteristics were as follows ; Those who monthly income over 2,010,000 won had lower than above 1,000,000 won, and those with the experience of chemotherapy had higher than those without, and the patient who has 7~12 months(1 yr.) post operation period had higher than the one below 6months, 25~36 months(3 yrs.), 37~60 months(5 yrs.), and over 61 months. 2. The mean anxiety score was 45.9. Anxiety tended to be increased slightly in subjects with low educational background, poor monthly income, experience of chemotherapy, and 7~12 months(1 yr.) post operation period, but there was no significant difference by general characteristics. 3. The mean value of the coping score was 100.7. The study revealed higher score in problem-focused coping than emotion-focused coping. In regard to coping by demographic characteristics were as follows ; those who had monthly income over 2,010,000 won had higher level of coping than those whose monthly income was between 1,010,000 and 2,000,000 won. In terms of problem- focused coping, those who had 25~36 months of post operation period showed significantly lower level of coping than those below 6 months or 37~60 months(5 yrs.) or over 61 months of post operation period. Regarding the emotion-focused coping, those with the christianity had significantly lower level of coping than those without it. Also, those whose monthly income over 2,010,000 won had significantly higher coping level than those with income of between 1,010,000 and 2,000,000 won. 4. A positive relationship was found between uncertainty and anxiety. Patients who experienced more uncertainty also showed more anxiety. Problem-focused coping was inversely related to uncertainty and anxiety. 5. The major variable that affected uncertainty was anxiety, explaining 63.3% of the uncertainty. In addition to this, it would explain 66.4% in total when experience of chemotherapy was added.
This study was conducted to investigate the correlation among uncertainty, mastery and appraisal of uncertainty in hospitalized children's mothers.
Self report questionnaires were used to measure the variables. Variables were uncertainty, mastery and appraisal of uncertainty. In data analysis, the SPSSWIN 12.0 program was utilized for descriptive statistics, Pearson's correlation coefficients, and regression analysis.
Reliability of the instruments was cronbach's alpha=.84~.94. Mastery negatively correlated with uncertainty(r=-.444, p=.000) and danger appraisal of uncertainty(r=-.514, p=.000). In regression of danger appraisal of uncertainty, uncertainty and mastery were significant predictors explaining 39.9%.
Mastery was a significant mediating factor between uncertainty and danger appraisal of uncertainty in hospitalized children's mothers. Therefore, nursing interventions which improve mastery must be developed for hospitalized children's mothers.
The purpose of this study was to explore the relationship of uncertainty, hope and quality of life in patients with breast cancer.
The subjects of the study were 113 breast cancer patients treated at 3 university hospitals in Daegu and Busan from June 1 to September 30, 2003. Uncertainty was measured by the Mishel Uncertainty in Illness Scale (MUIS), Hope was measured by Nowotny's Hope Scale, and quality of life by Ro's Korean Quality of Life(QOL). Data was analyzed with the SPSS program by t-test, ANOVA, Spearman's rank correlation and Multiple Regression Analysis.
The scores of uncertainty were negatively correlated with hope and QOL(all p's<0.05). Uncertainty revealed that there was a negative correlation among subitems of hope such as confidence, relationship with others, possibility of future, and inner motivation(r=-.333, p=.000; r=-.230, p=.015; r=-.260, p=.006; r=-.291, p=.003). Uncertainty also showed a negative correlation among subitems of QOL such as emotional status, self esteem, and relationship with family(r=-.29, p=.004; r=-.326, p=.000; r=-.197, p=.044), whereas hope revealed a positive correlation among subitems of QOL such as emotional status, self esteem, relationship with neighbor, and relationship with family(r=.243, p=.011; r=.487, p=.000; r=.29, p=.001; r=.29, p=.001). The score of uncertainty was low in graduate school students and subjects using problem solving as a coping method. However, the score of hope was high in college students and subjects using a problem solving method, and the score of QOL was high in professionals.
Based on the study results, breast cancer patients experienced living with uncertainty and maintaining hope. Thus the study's findings can be useful in directing a comprehensive nursing care plan to improve QOL of breast cancer patients.
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.
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.
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.
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.
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.
This concept analysis was done to clarify ‘uncertainty in epilepsy’.
Walker and Avant's methodology guided the analysis. In addition, the concept was compared with uncertainty in other health problems.
‘Uncertainty in epilepsy’ was defined as being in the condition as seen from the epilepsy experience where cues were difficult to understand because they changed, were in discord with past ones, or they had two or more contradictory values at the same time. Uncertainty in epilepsy is evolved from appraisal of the epilepsy experience. As a result, uncertainty leads epilepsy patients, their family or health care providers to impaired functioning and proactive/passive coping behavior.
Epilepsy patients with uncertainty need to be supported by nursing strategies for proactive, rational coping behavior. This achievement has implications for interventions aimed at changing perception of epilepsy patients, their families or health care providers who must deal with uncertainty.
This study was done to examine the relation of uncertainty, uncertainty appraisal, and self-management in patients undergoing hemodialysis, and to identify factors influencing self-management.
A convenience sample of 92 patients receiving hemodialysis was selected. Data were collected using a structured questionnaire and medical records. The collected data were analyzed using descriptive statistics, t-test, ANOVA, Pearson correlations and multiple regression analysis with the SPSS/WIN 20.0 program.
The participants showed a moderate level of uncertainty with the highest score being for ambiguity among the four uncertainty subdomains. Scores for uncertainty danger or opportunity appraisals were under the mid points. The participants were found to perform a high level of self-management such as diet control, management of arteriovenous fistula, exercise, medication, physical management, measurements of body weight and blood pressure, and social activity. The self-management of participants undergoing hemodialysis showed a significant relationship with uncertainty and uncertainty appraisal. The significant factors influencing self-management were uncertainty, uncertainty opportunity appraisal, hemodialysis duration, and having a spouse. These variables explained 32.8% of the variance in self-management.
The results suggest that intervention programs to reduce the level of uncertainty and to increase the level of uncertainty opportunity appraisal among patients would improve the self-management of hemodialysis patients.
This study was done to propose a structural model to explain and predict psychosocial adjustment in patients with early breast cancer and to test the model. The model was based on the Stress-Coping Model of Lazarus and Folkman (1984).
Data were collected from February 18 to March 18, 2009. For data analysis, 198 data sets were analyzed using SPSS/WIN12 and AMOS 7.0 version.
Social support, uncertainty, symptom experience, and coping had statistically significant direct, indirect and total effects on psychosocial adjustment, and optimism had significant indirect and total effects on psychosocial adjustment. These variables explained 57% of total variance of the psychosocial adjustment in patients with early breast cancer.
The results of the study indicate a need to enhance psychosocial adjustment of patients with early breast cancer by providing detailed structured information and various symptom alleviation programs to reduce perceived stresses such as uncertainty and symptom experience. They also suggest the need to establish support systems through participation of medical personnel and families in such programs, and to apply interventions strengthening coping methods to give the patients positive and optimistic beliefs.
The purpose of this study was to investigate the Quality of Life (QOL) and related factors in the patients with dizziness.
The data were collected between March and June 2008 for 200 individuals who agreed to participate in the study. Uncertainty (Uncertainty in illness scale), anxiety, depression (Hospital anxiety & depression scale) and Vestibular disability activities of daily living (Vestibular disability-activities of daily living [ADL] scale) as well as QOL (Dizziness Handicap Inventory) were measured.
The mean QOL score was 37.5 (±23.0). Monthly income, etiology of, frequency of, and total duration of dizziness were the significant factors related to QOL in these patients. Having had a fall, anxiety, depression, uncertainty and vestibular disability in daily living were also significant factors influencing QOL. In multiple regression analysis, anxiety, vestibular disability-ADL, falls, total duration of symptoms, uncertainty, and etiology of dizziness explained 41% of variance of QOL.
The level of QOL in our patients was moderate as compared to those in previous studies. Anxiety and vestibular disability were the most important factors predicting low QOL. Use of nursing intervention programs designed to relieve these factors should also result in improving the QOL in the patients with dizziness.