Content area
Full Text
Purpose: To examine the concept of uncertainty in illness and to propose an alternate model of uncertainty in the illness experience.
Organizing construct and methods: Following a review of the literature, Morse's description of concept analysis by critically appraising the literature was used as a guideline in examining the concept of uncertainty.
Findings: Characteristics of the illness situation-ambiguity, vagueness, unpredictability, unfamiliarity, inconsistency, and lack of information-underlie the process of uncertainty. Three attributes of the concept of uncertainty were identified as probability, temporality, and perception. Loss of personal control is often erroneously equated with uncertainty.
Conclusions: Uncertainty is a multidimensional concept that in its purest form is a neutral cognitive state and should not be mistaken for its emotional outcomes. To clarify the concept of uncertainty, further research is needed to determine the relationship of uncertainty to loss of control and psychosocial outcomes.
[Key words: uncertainty, concept analysis, psychosocial outcomes]
A state of uncertainty is a major component of all illness experiences and it affects psychosocial adaptation and outcomes of disease. Since Mishel's development of the uncertainty in illness model (1988) and her later reconceptualization of that model (1990), no concept analysis of uncertainty has been published in the nursing literature, despite the increasing popularity of this concept as a variable in nursing research. The purpose of this analysis is to examine the concept of uncertainty in illness and to propose an alternate model of uncertainty in the illness experience. Various exemplar cases from patients' experiences drawn from qualitative health research will be used to show the various dimensions of uncertainty and to define the concept.
Method
Morse's (2000) description of concept analysis by critically appraising the literature was used to guide this analysis. According to this method of concept analysis, the literature is appraised to explore the "pragmatic utility" (p. 334) of a concept to science as it is identified in a program of research. An extensive literature search using CINAHL and PsycLit was conducted in the years 1982 to 1999. All relevant resources containing the search term "uncertainty" and "uncertainty in illness" were examined. The search size was limited by including only the most important theoretical sources, and by narrowing the focus to primarily include sources focused on adult uncertainty in illness....