• 성인간호학회지
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• 제18권3호
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• pp.479-487
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• 2006

Purpose: The purposes of this study were to measure the degree of uncertainty in illness, hope, and spiritual well-being and to examine the relationship among uncertainty in illness, hope, and spiritual well-being of cancer patients. Method: The data were derived from answers to questionnaires obtained from 93 cancer patients at one general hospital in J area from April 6, 2004 to May 8, 2004. The collected data were analyzed by SSPS 10.0. Results: The mean score of uncertainty in illness of cancer patients was 55.96. The mean score of hope of cancer patients was 79.77, and spiritual well-being was 55.20. Uncertainty in illness of cancer patients was related negatively to hope(r=-.57, p=.000). Also uncertainty in illness of cancer patients was related negatively to spiritual well-being(r=-.57, p=.000). However, hope of cancer patients was related positively to spiritual well-being(r=.67, p=.000). Conclusion: Higher uncertainty in illness was related to lower hope and spiritual well-being of cancer patients. Based upon these results, nurses should help patients to improve their hope and spiritual well-being through mediation of uncertainty in illness.

• 성인간호학회지
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• 제20권1호
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• pp.1-9
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• 2008

Purposes: This study examined uncertainty and nursing need according to illness phases(phase I, II, III) in cancer patients, and investigated relationships between uncertainty and nursing need. Methods: A cross-sectional descriptive study was conducted with a sample of 121 adult cancer patients treated in two hospitals. Results: As for the total score, the uncertainty was not significantly different across the subgroups by illness phase. As for the subscale score, however, two sub-scales of the uncertainty were different across the subgroups. 'The unpredictability' was highest in illness phase I and II groups, while 'the lack of information' was highest in the illness phase III group. Nursing need as the total score was not significantly different across the subgroups by illness phase. However, all subscale scores of the nursing need were significantly different across the subgroups. Educational need was highest in the illness phase I group; physical and emotional needs were highest in the illness phase III group. Uncertainty and nursing need were not related to each other at any illness phase. Conclusion: The results suggest that nursing need and uncertainty may change across illness phases. Clinicians need to consider this pattern in caring for cancer patients.

• 대한간호학회지
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• 제33권8호
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• pp.1127-1134
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• 2003

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 ($\beta$=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<.0l). 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 (X$^2$) for the Q was statistically significant (df =3, p<.00l). 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.

• 대한간호학회지
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• 제24권4호
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• pp.529-544
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• 1994

For most parents their child's illness and hospitalization is strssful. Internal stress and over anxiousness leads to uncertainty. Parents have a variety of ways of coping when faced with such stress factors, especialy when the child has cancer. The purpose of this study was to examine the relationship between uncertainty in illness and mastery and coping styles in parents of pediatric cancer patients, and further to identify differences between three groups of subjects. A cross-sectional descriptive correlational design was used in this study to investigate the relationship among the three groups. The sample was composed of 59 parents of children with cancer in pediatric wards in three hospitals in Seoul : 21 in Group 4 with a child newly diagnosed with cancer : 25 in Group B, with a child under treatment and rehospitalized with a relapse : and 13 in Group C, with a child with a terminal cancer, A formalized questionnaire which included demegrapic information and consisted of 75 items was used in this study ; The Parent Perception of Uncertainty Scale(PPUS) adapted form Mishel’s Uncertainty in Illness Scale, Pearlin & Schooler's Mastery Scale(MS) and Folkman & Lazarus’s Ways of Coping Checklist(WCC) were used to measure the variables : uncertainty in illness, mastery, and coping styles. A pretest was conducted on the questionnaire items for reliability. The results gathered were analyzed using SPSS /PC/sup +/. Data analysis included descriptive correltional statistics such as ANOVA, Pearson Correlation Coefficient, amd chi square test. The conclusions of this analysis are summarized as follows : 1. A higher level of uncertainty was seen among parents of children with terminal cancer. 2. The first hypothesis that uncertainty in illness would differ among the three groups was supported(F=4.182, P=.020). The second and third hypotheses that mastery and coping styles would differ among the three groups were not supported. There was a correlation between uncertainty, mastery, and coping styles which was positive, also there was a positive correlation between mastery and coping style(r=.3744, P<.001) but a negative correlation between uncertainty md mastery(r=-.4749, P<.01). From the above results, it can be concluded that prediciting and controlling uncertainty in illness by considering coping styles and mastery are necessary for improved, efficient nursing interventions.

• Child Health Nursing Research
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• 제4권2호
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• pp.207-220
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• 1998

The purpose of this study was to build a substantive theory about the experience of the maternal uncertainty in childhood chronic illness. The qualitative research method used was grounded theory. The interviewees were 12 mothers who have cared for a child who had chronic illness. The data were collected through in-depth interviews with audiotape recording done by the investigator over a period of nine months. The data were analyzed simutaneously by a constant comparative method in which new data were continuously coded into categories and properties according to Strauss and Corbin's methodology. The 34 concepts were identified as a result of analyzing the grounded data. Ten categories emerged from the analysis. The categories were lack of clarity, unpredictability, unfamiliarity, negative change, anxiety, devotion normalization and burn-out. Causal conditions included : lack of clarity, unpredictability, unfamiliarity and change ; central phenomena : anxiety, being perplexed ; context. seriousness of illness, support ; intervening condition : belief action/interaction strategies devotion, overprotection ; consequences : normalization, burn-out. These categories were synthesized into the core concept-anxiety. The process of experiencing uncertainty was 1) Entering the world of uncertainty, 2) Struggling in the tunnel of uncertainty, 3) Reconstruction of the situation of uncertainty. Four hypotheses were derived from the analysis : (1) The higher the lack of clarity, unpredictability, unfamiliaity, change, the higher the level of uncertainty (2) The more serious the illness and the less the support, the higher the level of uncertainty. (3) The positive believes will influence the devoted care and normalization of the family life. Through this substantive theory, pediatric nurses can understand the process of experiencing maternal uncertainty in childhood chronic illness. Further research to build substantive theories to explain other uncertainties may contribute to a formal theory of how normalization is achieved in the family with chronically ill child.

• 근관절건강학회지
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• 제5권1호
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• pp.7-25
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• 1998

Rheumatoid arthritis, unlike other chronic diseases, causes the patients to experience uncertainty in their daily lives and thus to feel threat on their emotional comfort because of inconsistent and unpredictable symptoms such as pain. Therefore, a theoretical framework is needed for explanation of uncertainty in patients having rheumatoid arthritis. A hypothetical model was constructed on the basis of Mishel's Uncertainty Theory and other literature review. The model included 9 theoretical concepts and 19 paths. Subjects of the study constituted 330 partients who visited outpatient clinics of two university hospitals and one general hospital in Seoul. Self report questionnaires were used to measure the variables affecting uncertainty. Reliability coefficients of these instruments were found Cronbach's Alpha=$.70{\sim}.94$. In data analysis, SAS program and PC-LISREL 8.03 computer program were utilized for descriptive statistics and covariance structure analysis. The results of covariance structure analysis for model fitness were as follows : 1) Hypothetical model showed a good fit to the empirical data : Chi-square($X^2$)=41.81 (df=11, P=.000), Goodness of Fit Index=.974, Root Mean Square Residual=.049, Normed Fit Index=.928, Non Normed Fit Index=.814. 2) For the validity and the parcimony of model, a modified model was constructed by appending 2 paths and deleting 5 paths according to the criteria of statistical significance and meaningfulness. 3) The results of hypothesis testing were as follows : (1) Educational level, event familiarity and severity of illness had a direct effect on uncertainty : Event congruency had both direct and indirect effect on uncertainty : Credible authority and symptom consistency had a nonsignificant direct effect on uncertainty, (2) Illness duration, symptom consistency, and event congruency had a direct effect on severity of illness ; Credible authority had a both direct and indirect effect on severity of illness ; Event congruency had the greatest effect on severity of illness, and event familiarity had a nonsignificant direct effect on severity of illness.

• 근관절건강학회지
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• 제4권2호
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• pp.277-296
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• 1997

This study was conducted to investigate the influencing factors on the appraisal of uncertainty in patients having rheumatoid arthritis. Subjects of the study constituted 528 patients who visited outpatient clinics of two university hospitals and one general hospital in Seoul. Self report questionnaires were used to measure the variables influencing the appraisal of uncertainty. Reliability coefficients of these instruments were found Cronbach's Alpha=$.70{\sim}.96$. In data analysis, SPSS PC 6.0 program was utilized for descriptive statistics, Pearson's correlation, logistic and multiple regression analysis. The results of logistic and multiple regression analysis were as follows 1) Among the independent variables, significant factors to explain the appraisal of uncertainty in patients were uncertainty(p<.001), severity of illness(p<.05), educational level (p<.05) and age (p<.05). 2) When patients appraised uncertainty as "Danger", significant factors to explain the appraisal of uncertainty were uncertainty(p<.0001), age(p<.0005), severity of illness(p<.001), educational level (p<.05). 3) When patients appraised uncertainty as "Opportunity", significant factors to predict the appraisal of uncertainty were uncertainty(p<.0005), social support(p<.0005), severity of illness(p<.005), credible authority(p<.05), age(p<.05) and educational level (p<.05).

• Child Health Nursing Research
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• 제2권2호
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• pp.5-18
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• 1996

The purposes of this study were to measure the degree of perceived uncertainty and to identify the rearing attitudes of mothers with chronically ill children, and to examine the relationship between the perceived uncertainty and the rearing attitude of these mothers. The subjects of this study consisted of 133 mothers with chronically ill children, registered at 2 university hospitals in Seoul. Data was collected from April 1 to May 31, 1996. The Parents' Perception of Uncertainty Scale(28-item 4 point scale) and the Maternal Behavior Research Instrument (49-item 5 point scale) were used. Data was analyzed by Cluster analysis, ANOVA MANOVA and t-test. Results of this study are summarized as follows : 1. Mothers perceived their uncertainty to be slightly high (Mn 2.48). The degree of perceived uncertainty by the four components slightly differed unpredictability(2.72), lack in clarity(2.58), vagueness (2.52) and lack of information(2.04) . The degree of perceived uncertainty of mothers with ill children revealed to be influenced significantly by the age of the ill children, duration of illness after the diagnosis, and the experience of hospitalization. 2. Among the rearing attitudes : moderatlely high affective(Mn 3.98) and resrictive(Mn 3.58) attitudes of mothers toward their ill children were identified. Mothers tend to give positive evaluations of their childrens' behaviors (Mn 3.38) and less rejection(Mn 2.81). 3. Mothers' rearing attitude were correlated with the degree of perceived uncertainty in illness ; mothers in the Low Perceived Uncertainty Group (Mn 1.99) revealed the highest affective (Mn 4.08), the lowest resrictive(Mn. 2.72) attitudes and tendency to give positive evaluations of their childrens' behaviors (Mn 3.54) compared to the High Perceived Uncertainty Group(Mn 3.26) and Moderate Perceived Uncertaity Group(Mn 2.57). 4. The degree of perceived uncertainty, the duration of illness after the diagnosis and the experience of hospitalization revealed to be significantly influential to the rearing attitude of mothers with chronically ill children. From the above results, it can be concluded that predicting and controlling mothers' uncertainty are necessary for improved, efficient nursing interventions and normal growth & development of the chronically ill children.

• 성인간호학회지
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• 제15권1호
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• pp.146-153
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• 2003

연구목적: 본 연구는 대표적인 중간범위 간호이론인 Mishel의 Uncertainty in Illness모델에 관한 연구문헌 고찰이다. 기존의 간호이론에 근거해서 새로운 간호연구가 시행되고 있으며, 이러한 연구들의 결과는 또한, 근거이론을 지지 및 수정보완을 통해서 간호이론의 타당성과 유용성을 강화해왔다. Mishel의 모델에 근거한 불확실감에 관한 연구의 수행에 앞서, 근거이론에 관한 현지식의 상태와 부족한 영역을 탐구하여, 이에 기여할 수 있는 연구계획을 수립하는데 문헌고찰의 주요한 목적이 있다. 연구방법: 본 문헌고찰은 중간범위 간호이론인 Mishel's Uncertainty in Illness에서의 주요 개념간의 관계에 대해서 선행연구 결과를 토대로 분석하였다. 연구결과: 불확실감의 선행요소들(antecedents)과 불확실감, 불확실감의 평가(appraisal of uncertainty), 불확실감 모델내에서 건강 통제위(health locus of control)의 역할, 및 불확실감의 결과, 적응(adaptation)에 관하여 고찰하였다. 결론: 문헌고찰 결과로서, 불확실감 이론에 관한 현지식의 상태를 확인하였고 이 이론의 타당성과 유용성을 확인하기 위한 추후연구에 대한 방향도 제언되었다.

• 대한간호학회지
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• 제54권2호
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• pp.162-177
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• 2024

Purpose: This study aimed to investigate the influence of uncertainty-related factors on the health behavior of individuals with coronary artery disease (CAD) based on Mishel's uncertainty in illness theory (UIT). Methods: We conducted a cross-sectional study and path analysis to investigate uncertainty and factors related to health behavior. The study participants were 228 CAD patients who visited the outpatient cardiology department between September 2020 and June 2021. We used SPSS 25.0 and AMOS 25.0 software to analyze the data. Results: The final model demonstrated a good fit with the data. Eleven of the twelve paths were significant. Uncertainty positively affected danger and negatively affected self-efficacy and opportunity. Danger had a positive effect on perceived risk. Opportunity positively affected social support, self-efficacy, perceived benefit and intention, whereas it negatively affected perceived risk. Social support, self-efficacy, perceived benefit and intention had a positive effect on health behavior. We found that perceived benefit and intention had the most significant direct effects, whereas self-efficacy indirectly affected the relationship between uncertainty and health behavior. Conclusion: The path model is suitable for predicting the health behavior of CAD patients who experience uncertainty. When patients experience uncertainty, interventions to increase their self-efficacy are required first. Additionally, we need to develop programs that quickly shift to appraisal uncertainty as an opportunity, increase perceived benefits of health behavior, and improve intentions.