Uncertainty In Nursing Theory

Uncertainty in illness is a middle range nursing theory that explains how the patient copes with and processes uncertainty when faced with the challenges of acute or chronic illnesses. The uncertainty in illness theory explains how the patient’s cognitively react when experiencing illness and a relationship on how it will affect their overall well-being. The theory explains that you can view uncertainty as an opportunity or as a danger. Nurses can provide support and implement intervention to aid the patients in coping the quality of a patient is improved. Uncertainty in the theory is described as either a negative or positive state. Uncertainty is a stressor in illness. The framework of this theory makes it easily meaningful to nurses. Uncertainty

The primary antecedents’ variable involves the stimuli frame which refers to the form, composition, and structure of the stimuli that the person perceives. The stimuli frame has three components that work together to decrease uncertainty: symptom pattern, event familiarity, and event congruence. These three components provide the stimuli that are structured by the patient into a cognitive schema, which creates less uncertainty. Cognitive schema refers to the patient’s subjective interpretation of illness, treatment or hospitalization (Mishel). Symptom pattern is the degree to which symptoms present with a pattern and based on this pattern the meaning of the symptoms can be determined. Event familiarity is the degree to which the situation is repetitive, or contains recognized clues. Event congruence refers to the consistency between what is expected and what is experienced in illness-related events (Mishel). These three components of the stimuli frame are influenced by two variables: cognitive capacity and structure providers. Cognitive capacity refers to the information processing abilities of the person. Limited ability to process will decrease the ability to perceive symptoms pattern, event familiarity, and the congruence of events therefore increasing uncertainty. Structure providers are the resources available to assist the person to interpret the stimuli frame and include educational level, social support and credible authority.

The second article I reviewed was Dementia and Caregiver Stress: An Application of the Reconceptualized Uncertainty in Illness Theory. This is a qualitative study involving four focus groups with six-ten volunteer participants were held, each last approximately 90 minutes. 15 caregivers cared for their parents and the remainder cared for their spouses. Multiple themes (Antecedents) emerged from the interviews and were categorized by the five dimensions of uncertainty of illness. Four of the five themes causing uncertainty involved dementia related symptoms and included lack of personal boundaries, repetitive behavior, hygiene, verbal and physical aggressiveness, and need for constant care. The fifth theme involved the loss of freedom. The cognitive capacity in this study refer to the caregiver’s information processing ability. Structure Providers: Institutional care quality was the single theme in this category. Appraisals were mostly negative and included feelings of resentment, a lack of support from family members, financial strain, and loss of freedom. Coping strategies included support groups, caring for one’s self, religion, and humor. This study found that caregivers experience uncertainty in similar ways to patients who have life altering