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Choi M, Lee J, Oh EG, Chu SH, Sohn YH, Park CG. Factors Associated With Uncertainty in Illness Among People With Parkinson's Disease. Clin Nurs Res 2018; 29:469-478. [PMID: 30019611 DOI: 10.1177/1054773818788492] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
People with Parkinson's disease (PD) reported to experience uncertainty because of gradually progressive disease characteristics with no cure, and variably manifesting and unpredictable symptoms. This study was designed to identify illness-related variables influencing uncertainty in PD patients and to analyze direct and indirect paths between these variables. Data were collected from 206 participants using a structured questionnaire. Path analysis revealed the direct and/or indirect effects of economic status, disease severity, social support, and resilience on uncertainty in people with PD. Disease severity, social support, and resilience were shown to have significant direct effects on uncertainty. Economic status and disease severity had indirect effects on uncertainty, which were mediated by social support. Disease severity and social support also had indirect effects on uncertainty, which were mediated by resilience. Therefore, the efforts of health care professionals should be directed not only toward managing PD symptoms, but also toward facilitating social support and resilience.
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Affiliation(s)
- MoonKi Choi
- Department of Nursing, Bucheon University, South Korea
| | - JuHee Lee
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Eui Geum Oh
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Sang Hui Chu
- Mo-Im Kim Nursing Research Institute, College of Nursing, Yonsei University, Seoul, South Korea
| | - Young H Sohn
- College of Medicine, Yonsei University, Seoul, South Korea
| | - Chang Gi Park
- College of Nursing, The University of Illinois at Chicago, USA
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Subih M, Al-Kalaldeh M, Salami I, Al-Hadid L, Abu-Sharour L. Predictors of uncertainty among postdischarge coronary artery bypass graft patients in Jordan. JOURNAL OF VASCULAR NURSING 2018; 36:85-90. [PMID: 29747788 DOI: 10.1016/j.jvn.2017.11.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2017] [Revised: 11/19/2017] [Accepted: 11/23/2017] [Indexed: 11/16/2022]
Abstract
Uncertainty impacts negatively on adaptation and disease outcomes. During recovery, coronary artery bypass graft (CABG) patients experience uncertainty, symptom distress, and learning needs. This study aimed to examine predictors associated with uncertainty among CABG patients. This cross-sectional correlational study recruited CABG patients conveniently from out-patient clinics 1 month after discharge. Participants completed a self-administered questionnaire which included: demographic questionnaire, Mishel's Uncertainty of Illness Scale, Cardiac Symptoms Survey, and Cardiac Patients Learning Needs. A total of 161 participants completed the study questionnaires. Participants showed a moderate level of uncertainty, less cardiac symptom distress, and high learning needs. Uncertainty was significantly correlated with learning needs while less correlated with symptom distress. Hierarchal multiple regression revealed that gender, employment status, education level, and learning needs are factors associated with uncertainty among CABG patients. It was concluded that symptom distress does not necessarily induce uncertainty. Intensive care professionals should undertake individual's characteristics to anticipate uncertainty.
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Affiliation(s)
- Maha Subih
- School of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
| | | | - Ibrahim Salami
- Faculty of Nursing, The University of Jordan, Amman, Jordan
| | - Lourance Al-Hadid
- Nursing Department, Al Hussein Bin Talal University, Princess Aisha Bint Al Hussein College of Nursing and Health Sciences, Ma'an, Jordan
| | - Loai Abu-Sharour
- Faculty of Nursing, Al-Zaytoonah University of Jordan, Amman, Jordan
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Hedberg B, Malm D, Karlsson JE, Årestedt K, Broström A. Factors associated with confidence in decision making and satisfaction with risk communication among patients with atrial fibrillation. Eur J Cardiovasc Nurs 2017; 17:446-455. [DOI: 10.1177/1474515117741891] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Background: Atrial fibrillation is a prevalent cardiac arrhythmia. Effective communication of risks (e.g. stroke risk) and benefits of treatment (e.g. oral anticoagulants) is crucial for the process of shared decision making. Aim: The aim of this study was to explore factors associated with confidence in decision making and satisfaction with risk communication after a follow-up visit among patients who three months earlier had visited an emergency room for atrial fibrillation related symptoms. Methods: A cross-sectional design was used and 322 patients (34% women), mean age 66.1 years (SD 10.5 years) with atrial fibrillation were included in the south of Sweden. Clinical examinations were done post an atrial fibrillation episode. Self-rating scales for communication (Combined Outcome Measure for Risk Communication and Treatment Decision Making Effectiveness), uncertainty in illness (Mishel Uncertainty in Illness Scale–Community), mastery of daily life (Mastery Scale), depressive symptoms (Hospital Anxiety and Depression Scale) and vitality, physical health and mental health (36-item Short Form Health Survey) were used to collect data. Results: Decreased vitality and mastery of daily life, as well as increased uncertainty in illness, were independently associated with lower confidence in decision making. Absence of hypertension and increased uncertainty in illness were independently associated with lower satisfaction with risk communication. Clinical atrial fibrillation variables or depressive symptoms were not associated with satisfaction with confidence in decision making or satisfaction with risk communication. The final models explained 29.1% and 29.5% of the variance in confidence in decision making and satisfaction with risk communication. Conclusion: Confidence in decision making is associated with decreased vitality and mastery of daily life, as well as increased uncertainty in illness, while absence of hypertension and increased uncertainty in illness are associated with risk communication satisfaction.
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Affiliation(s)
- Berith Hedberg
- Jönköping Academy for Health and Welfare, Jönköping University, Sweden
- Region Jönköpings län, Futurum, Jönköping, Sweden
| | - Dan Malm
- Department of Nursing Science, School of Health Sciences, Jönköping University, Sweden
- Ryhov County Hospital, Region Jönköpings län Jönköping, Sweden
| | - Jan-Erik Karlsson
- Jönköping Academy for Health and Welfare, Jönköping University, Sweden
- Department of Internal Medicine, Department of Medical and Health Sciences, Linköping University, Sweden
| | - Kristofer Årestedt
- Faculty of Health and Life Sciences, Linnaeus University, Kalmar, Sweden
- Department of Medicine and Health Sciences, Linköping University, Sweden
| | - Anders Broström
- Department of Nursing Science, School of Health Sciences, Jönköping University, Sweden
- Department of Clinical Neurophysiology, Linköping University Hospital, Sweden
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Uncertainty and Personal Growth Through Positive Coping Strategies Among Chinese Parents of Children With Acute Leukemia. Cancer Nurs 2016; 39:205-12. [DOI: 10.1097/ncc.0000000000000279] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Hoth KF, Wamboldt FS, Ford DW, Sandhaus RA, Strange C, Bekelman DB, Holm KE. The social environment and illness uncertainty in chronic obstructive pulmonary disease. Int J Behav Med 2015; 22:223-32. [PMID: 25008041 PMCID: PMC4289471 DOI: 10.1007/s12529-014-9423-5] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
PURPOSE Illness uncertainty is associated with worse outcomes in patients with chronic health conditions. Research on social factors associated with uncertainty has focused on the beneficial role of social support. The goal of this study was to develop a more nuanced understanding of the social factors that are associated with uncertainty. METHODS Four hundred sixty-two individuals with alpha-1 antitrypsin deficiency (AATD)-associated chronic obstructive pulmonary disease (COPD) completed a mailed questionnaire. Measures of the social environment included general family functioning, perceived criticism from family members, whether the participant had family members with AATD or COPD, and participation in support groups. Uncertainty was measured using the Mishel Uncertainty in Illness Scale including subscales for ambiguity (uncertainty about physical cues and symptoms) and complexity (uncertainty about treatment and the medical system). Hierarchical regression was used to identify social correlates of ambiguity and complexity while adjusting for demographic and medical characteristics and psychological distress. RESULTS Perceived criticism was associated with more complexity (b = 0.21, SE = 0.09, p = 0.015) and ambiguity (b = 0.40, SE = 0.12, p = 0.001). Having a family member with AATD or COPD was associated with more ambiguity (b = 3.28, SE = 1.00, p = 0.001). Participation in support groups was associated with less ambiguity. Individuals who attended three or more support groups in the prior year reported less ambiguity than individuals who had not attended any (b = -3.31, SE = 1.29, p = 0.010). CONCLUSIONS The social environment is complex and encompasses more than social support. Multiple aspects of the social environment are associated with uncertainty, including perceived criticism, having a family member with a similar illness, and participation in support groups.
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Affiliation(s)
- Karin F Hoth
- Department of Psychiatry, University of Iowa Carver College of Medicine, 200 Hawkins Drive, W278GH, Iowa City, IA, 52242, USA,
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Cleanthous S, Newman S, Shipley M, Isenberg D, Cano S. What constitutes uncertainty in systemic lupus erythematosus and rheumatoid arthritis? Psychol Health 2013; 28:171-88. [DOI: 10.1080/08870446.2012.701628] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Kosenko KA, Hurley RJ, Harvey JA. Sources of the uncertainty experienced by women with HPV. QUALITATIVE HEALTH RESEARCH 2012; 22:534-545. [PMID: 22068044 DOI: 10.1177/1049732311424404] [Citation(s) in RCA: 19] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Women with genital human papillomavirus (HPV) experience considerable stress and uncertainty as a result of the diagnosis; however, little is known about the sources of uncertainty in HPV. Given that uncertainty creates stress, which might be linked to the pathogenesis of cervical cancer, research on these sources of uncertainty is warranted. To this end, we completed semistructured interviews with 25 women living with HPV, and identified seven sources of uncertainty: The meaning of the diagnosis, the potential for disease progression, finances, the source of the infection, disclosure, sex and reproduction, and the HPV vaccine. In the discussion we articulate the relevance and importance of study findings to research, theory, and practice.
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Affiliation(s)
- Kami A Kosenko
- North Carolina State University, Raleigh, North Carolina 27695, USA.
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Kang Y. The relationships between uncertainty and its antecedents in Korean patients with atrial fibrillation. J Clin Nurs 2011; 20:1880-6. [DOI: 10.1111/j.1365-2702.2010.03416.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Vagharseyyedin SA, Vanaki Z. Validation of the Iranian version of the Uncertainty In Illness Scale - Family form. J Res Nurs 2010. [DOI: 10.1177/1744987110366201] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
This study aimed to evaluate the reliability and validity of the Iranian version of the Uncertainty In Illness Scale — Family form. For this purpose, the Uncertainty In Illness Scale — Family form was translated from English into Persian and tested for psychometric properties. The analyses were carried out with data from a sample of 310 patients’ family members at one general hospital in Birjand city, the center of the Southern Khorasan province. The Iranian version of the Uncertainty In Illness Scale — Family form demonstrated an acceptable level of content validity with a content validity index of 0.91. The Cronbach’s alpha of 0.83 showed that the scale had reasonable internal consistency. This preliminary validation study of the Iranian version of the Uncertainty In Illness Scale — Family form showed that it is an acceptable measure to be used with Iranian patients’ family members. Additional research is recommended for further evaluation of the psychometric properties of the scale.
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Affiliation(s)
| | - Zohreh Vanaki
- Faculty member, Department of Nursing, Medical Sciences college, Tarbiat Modares University, Tehran, Iran
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Hardin SR, Steele JR. Atrial fibrillation among older adults: pathophysiology, symptoms, and treatment. J Gerontol Nurs 2008; 34:26-33; quiz 34-5. [PMID: 18649821 DOI: 10.3928/00989134-20080701-04] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Abstract
Atrial fibrillation is the most common arrhythmia among older adults. Valvular heart disease, dilated cardiomyopathy, aortic stenosis, hypertension, coronary artery disease, pericarditis, thyrotoxicosis, pulmonary disease, cardiac surgery, alcohol excess, and alcohol withdrawal are associated with atrial fibrillation. Nurses caring for older adults need to understand the condition's pathophysiology, signs and symptoms, diagnostic data and treatment protocols, and adherence issues to prevent the formation of emboli in chronic atrial fibrillation and to understand treatment of this common arrhythmia. This article presents an individual example of an elderly man exhibiting a new onset of atrial fibrillation and the interventions required to manage the associated complications. Atrial fibrillation places patients at risk for stroke from a thromboembolism; thus, pharmacological and nonpharmocological care strategies for managing patients with atrial fibrillation are discussed.
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Affiliation(s)
- Sonya R Hardin
- School of Nursing, University of North Carolina at Charlotte, Charlotte, NC 28223, USA.
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Koponen L, Rekola L, Ruotsalainen T, Lehto M, Leino‐Kilpi H, Voipio‐Pulkki L. Patient knowledge of atrial fibrillation: 3‐month follow‐up after an emergency room visit. J Adv Nurs 2007; 61:51-61. [DOI: 10.1111/j.1365-2648.2007.04465.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Leena Koponen
- Leena Koponen PhD RN
Leading Nursing Director
Helsinki University Central Hospital, Helsinki, Finland
| | - Leena Rekola
- Leena Rekola PhD RN
Senior Lecturer
Helsinki Polytechnic, Helsinki, Finland
| | - Taru Ruotsalainen
- Taru Ruotsalainen PhD RN
Senior Lecturer
Helsinki Polytechnic, Helsinki, Finland
| | - Mika Lehto
- Mika Lehto MD
Resident of Cardiology
Helsinki University Hospital, Helsinki, Finland
| | - Helena Leino‐Kilpi
- Helena Leino‐Kilpi PhD RN
Professor, Head of Department of Nursing Science and Turku University Hospital, Turun yliopisto, Finland
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Abstract
Cardiovascular nursing practice includes accountability for the clinical and organizational processes to ensure positive outcomes for patients having cardiac dysrhythmias. For patients with supraventricular dysrhythmias, nurses have studied patient outcomes related to mortality, morbidity, quality of life, psychological and physical functioning, and symptoms. Nurses have also explored these same outcomes associated with the management of supraventricular dysrhythmias. In addition, nurses have contributed to understanding organizational outcomes such as healthcare utilization and costs associated with these patients. For patients with atrial fibrillation after cardiac surgery, nurses have studied patient and organizational outcomes related to mortality, morbidity, symptoms, psychological and physical functioning, and economic outcomes. This research has included numerous interdisciplinary studies, and most of it has been descriptive or observational in design. Areas for future nursing outcomes research, including more interventional studies, are discussed.
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Affiliation(s)
- Marjorie Funk
- Yale University School of Nursing, New Haven, CT, USA
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