• Journal of Korean Academy of Nursing
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• v.48 no.4
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• pp.485-496
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• 2018

Purpose: 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. Methods: 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. Results: 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 (${\beta}=.64$, p<.001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=4.54, p<.001). Uncertainty opportunity appraisal (${\beta}=-.45$, p<.001) had a complete mediating effect in the relation between uncertainty and anxiety (Z=3.28, p<.001). Emotion-focused coping (${\beta}=-.23$, p=.021) had a partial mediating effect in the relation between uncertainty and anxiety (Z=2.02, p=.044). Conclusion: 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.

• Journal of Preventive Medicine and Public Health
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• v.43 no.4
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• pp.352-361
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• 2010

Objectives: This study estimated the annual socioeconomic costs of food-borne disease in 2008 from a societal perspective and using a cost-of-illness method. Methods: Our model employed a comprehensive set of diagnostic disease codes to define food-borne diseases with using the Korea National Health Insurance (KNHI) reimbursement data. This study classified the food borne illness as three types of symptoms according to the severity of the illness: mild, moderate, severe. In addition to the traditional method of assessing the cost-of-illness, the study included measures to account for the lost quality of life. We estimated the cost of the lost quality of life using quality-adjusted life years and a visual analog scale. The direct cost included medical and medication costs, and the non-medical costs included transportation costs, caregiver's cost and administration costs. The lost productivity costs included lost workdays due to illness and lost earnings due to premature death. Results: The study found the estimated annual socioeconomic costs of food-borne disease in 2008 were 954.9 billion won (735.3 billion won-996.9 billion won). The medical cost was 73.4 -76.8% of the cost, the lost productivity cost was 22.6% and the cost of the lost quality of life was 26.0%. Conclusions: Most of the cost-of-illness studies are known to have underestimated the actual socioeconomic costs of the subjects, and these studies excluded many important social costs, such as the value of pain, suffering and functional disability. The study addressed the uncertainty related to estimating the socioeconomic costs of food-borne disease as well as the updated cost estimates. Our estimates could contribute to develop and evaluate policies for food-borne disease.

• Korean Parent-Child Health Journal
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• v.15 no.2
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• pp.80-88
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• 2012

Purpose: This study was done to investigate the level of uncertainty, transfer anxiety, and to identify the participant's characteristics those influence them by targeting the mothers of transferred patients from the pediatric Intensive Care Unit (PICU) to the general ward. Methods: This study was a descriptive correlational study. The participants were 94 mothers of children who had been scheduled to transfer from the PICU. Results: The item mean score for uncertainty was 2.16 (4 scale), transfer anxiety was 2.15 (4 scale). There were statistically significant positive correlation between uncertainty and transfer anxiety (r=.591). The level of uncertainty significantly differed according to education level (p=.035), duration of marriage (p=.043), and monthly income (p=.022). The level of transfer anxiety significantly differed according to religion (p=.044), duration of marriage (p=.043), and severity of illness at transfer (p=.047). Conclusion: In order to reduce the transfer anxiety and uncertainty of the mothers of patients, efficient communication with medical staff and clear informations are needed to reduce ambiguity. Also, standard protocol should be developed for improving communication among medical staffs.

• Journal of Korean Academy of Nursing
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• v.39 no.5
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• pp.751-758
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• 2009

Purpose: The purpose of this study was to investigate the Quality of Life (QOL) and related factors in the patients with dizziness. Methods: 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. Results: The mean QOL score was 37.5 (${\pm}23.0$). 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. Conclusion: 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.

• Asian Oncology Nursing
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• v.7 no.2
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• pp.107-118
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• 2007

Purpose: The purpose of this study was to provide the basic data for development of nursing intervention to decrease the uncertainty in cancer patients having chemotherapy through promoting their spiritual health and identifying the relationship between spiritual health and uncertainty. Method: 174 cancer patients who were admitted for chemotherapy at hospital were recruited from the 7th March to the 10th April, 2006. Two instruments have been used for this study. One was Highfield's Spiritual Health Inventory and the other was Mishel's MUIS(Mishel Uncertainty in Illness Scale). The collected data was analyzed by frequency, percentage, mean value, average mean, standard deviation, t-test, Scheffe's test, ANOVA and Pearson Correlation Coefficients with the SPSS PC 12.0 program. Results: The average mean value of the spiritual health $3.50{\pm}\;.48$ and the uncertainty was $1.91{\pm}\;.46$. It meant that the relationships between spiritual health and uncertainty were shown to have a moderately negative correlation(r=-.489, p= .000). This means that the greater is the spiritual health, the less is the patient's uncertainty. Conclusions: It was identified that cancer patients having chemotherapy had moderate spiritual health and uncertainty, and negative correlation between spiritual health and uncertainty. Therefore, it will be necessary for the development of spiritual nursing intervention strategies to relieve the uncertainty among cancer patients having chemotherapy.

• The Korean Journal of Health Service Management
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• v.9 no.4
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• pp.105-117
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• 2015

Objectives : The aim of this study was to investigate the relationship among uncertainty, self-care agency and physiological index in acute myocardial infarction (AMI) patients who underwent primary percutaneous coronary intervention. Methods : A total of 196 patients who were admitted C National University Hospital from Oct 2014 to Jun 2015 participated in the study. Data were collected with a questionnaire, and the blood pressure, HgA1C, and lipid profile levels of the patients were acquired. Results : The mean age was 69.2 (${\pm}13.0$) years, and 74 % of the patients were men. The mean score for uncertainty in illness was 48.7 (${\pm}8.8$). The mean score for self-care agency was 73.3 (${\pm}13.4$). Self-care agency showed a negative correlation with uncertainty (r=-.579, p<.001), age (r=-.732, p<.001), systolic blood pressure (r=-.265, p=.001) and HgA1C (r=-.293, p<.001). Conclusions : The results of this study can be used to develop a nursing program that prevents AMI and to improve the clinical prognosis of AMI patients.

• Journal of Korean Academy of Nursing
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• v.18 no.3
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• pp.231-238
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• 1988

The purpose of this study was to assess and compare discrepancy in the scores of uncertainty perceived by patients and nurses' interperson perception. For this study, 124 hospitalized patients and the same numbered nurses assigned for direct care of each 124 patients were selected from general ward of C. University Hospital in Seoul during the time period from September to November 1987. Degree of uncertainty was measured by 27 items modified from Mishel Uncertainty in Illness Scale (MUIS), and was utilized by a Likert type scale The data were analysed by Mcnemar-test. Unpaired t-test. ANOVA, Scheffe - test and Stepwise multiple regression. The results are summarized as follows : 1. The discrepancy in the scores of uncertainty perceived by patients and nurses' interperson perception showed significant differences in 23 of 27 items : 11 of 23 items showed that the scores of patients' perception of uncertainty were higher than that of nurses' interperson perception of uncertainty. but 12 of 23 items were revealed reversely. 2. With regard to nurse's demographic variables, the discrepancy scores were the higest in the group under 22 years of age (F＝3.20, p＝.026) and in the group less than 1 year of nursing experience among 4 groups (F＝4.41, p＝.006). 3. The discrepancy scores had a tendency to be lowered in the higher age group(r＝ -.27. p＝.0026) and in the longer experienced group (r＝-.25, p＝.0052). 4. The most important variable affecting the discrepancy scores was identified to be the nurses' age which acounted for 7.2% fo the total variances in the stepwise multiple regression analysis. This was followed by patient hospital days which accounted for an additional 4.5% of the total variances. To conclude, the discrepancy in the scores of uncertainty perceived by patients and nurses' interperson perception showed significant differences in 23 of 27 items. The discrepancy scores of uncertainty had a tendancy to be lowered in the higher age group and in the longer experienced group.

• Journal of Korean Academy of Nursing
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• v.31 no.2
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• pp.244-256
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• 2001

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. 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.

• Korean Journal of Adult Nursing
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• v.25 no.1
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• pp.13-23
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• 2013

Purpose: The purpose of this study was to investigate the factors that influence health-related quality of life in patients with atrial fibrillation. Methods: The subjects were 150 outpatients with atrial fibrillation who visited the cardiology clinic of a university hospital in U city. The instruments used for this study were Mhel Uncertainty in Illness Scale (MUIS), Center for Epidemiologic Studies-Depression Scale (CES-D), State Trait Anxiety Inventory (STAI), and the Short-Form-36 Health Survey (SF-36) Korean version II. The date were analyzed by ANOVA, Pearson-correlation coefficient, and hierachial multiple regression using SPSS/WIN 18.0. Results: The mean score of physical health-related quality of life (PCS) was $38.92{\pm}6.22$ and mental health-related quality of life (MCS) was $41.49{\pm}5.71$. Physical and Mental health-related quality of life had the significant correlations with uncertainty, anxiety and depression. In multiple regression analysis, physical health-related quality of life was significantly influenced by duration of disease, NYHA class, uncertainty. Mental health-related quality of life was significantly influenced by family income, NYHA class, anxiety and depression. Conclusion: These results suggest that these influencing factors should be consider in developing the nursing interventions to improve the healthrelated quality of life in patients with atrial fibrillation.

• Journal of Korean Clinical Nursing Research
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• v.21 no.2
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• pp.223-233
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• 2015

Purpose: This study was done to investigate the correlation of uncertainty, coping and health-promoting behavior in patients with gastric cancer who have undergone a gastrectomy. Methods: A descriptive correlational design was used and the participants were 120 gastric cancer patients from one general hospital. The structured questionnaire included Mishle's Uncertainty in Illness Scale, the Korean Cancer Coping Questionnaire, and the Health Promoting Lifestyle Profile. Data were analyzed using descriptive statistics, t-test, one-way ANOVA, Pearson correlation coefficient, and multiple regression analysis. Results: There were significant negative correlations between uncertainty and intrapersonal coping (r=-.657, p<.001); between uncertainty and interpersonal coping (r=-.223, p=.014); and between uncertainty and health promoting behavior (r=-.594, p<.001). There were significant positive correlations between intrapersonal coping and health promoting behavior (r=.790, p<.001); and between interpersonal coping and health promoting behavior (r=.502, p<.001). Uncertainty, intrapersonal coping, and interpersonal coping explained 49% of health promoting behavior (F=21.312, p<.001). The factors that influenced health promoting behavior were intrapersonal coping (${\beta}=.582$, p<.001), and interpersonal coping (${\beta}=.246$, p<.001). Conclusion: The findings of this study indicate that intrapersonal coping and interpersonal coping were significant variables for health promoting behavior in patients with gastric cancer who had undergone a gastrectomy in the past six months.