Rationale, aims and objectives: According to an influential taxonomy of varieties of uncertainty in health care, existential uncertainty is a key aspect of uncertainty for patients.Although the term "existential uncertainty" appears across a number of disciplines in the research literature, its use is diffuse and inconsistent. To date there has not been a systematic attempt to define it. The aim of this study is to generate a theoretically-informed conceptualisation of existential uncertainty within the context of an established taxonomy.Method: Existential uncertainty was subjected to a concept analysis, which drew on existing uses of the term across multiple disciplines as well as insights from uncertainty theory more broadly and from the existential therapy literature to generate a tentative definition of the concept. Antecedents, consequences, and empirical referents of existential uncertainty were also identified. A model case was described as well as a borderline case and a related case in order to illustrate and delineate the concept.Results: Existential uncertainty is conceptualised as an awareness of the undetermined but finite nature of one's own being-in-the-world, concerned primarily with identity, meaning, and choice. This awareness is fundamental and ineradicable, and manifests at different levels of consciousness. Conclusion:Humans rely on identity, worldview, and a sense of meaning in life as ways of managing the ineradicable uncertainty of our being-in-the-world, and these can be challenged by a serious diagnosis. It is important that medical professionals acknowledge issues around existential uncertainty as well as issues around scientific uncertainty, and recognise when patients might be struggling with these. Further research is required to identify ways of measuring existential uncertainty and to develop appropriate interventions, but it is hoped that this conceptualisation provides a useful first step towards that goal.
Many cancers are linked to varying degrees with common lifestyle factors such as smoking, drinking and diet, and are therefore partially preventable. Building on existing risk perception literature, this article uses the case of red meat consumption to examine the effect of people's attitudes and attitude ambivalence on health risk perceptions where there is some uncertainty about the risk. Data was obtained from an opportunity sample of community-dwelling adults (n = 167) using an online survey.The survey included information from a recent press release on the cancer risk associated with red meat consumption ('probably carcinogenic') as well as measures of attitude to red meat, attitude ambivalence, ambiguity aversion, information evaluation and acceptance of cancer risk. Participants who were more inclined to accept the risk of cancer linked to red meat tended to have a more negative attitude to red meat, higher attitude ambivalence, more favourable evaluation of the information provided, lower ambiguity aversion and lower red meat consumption; they also tended to be of older age. Attitude was a weaker predictor of risk perception among participants who were highly ambivalent. This, coupled with the finding that people with an ambivalent attitude to red meat evaluated the risk information more favourably and were more convinced that red meat can cause cancer, suggests that attitude ambivalence may play a more important role in risk perception than previously thought. These findings are discussed in the context of strategies for dealing with risk when drawing on rational and non-rational logics of handling evidence.
Objective To delimit the concept of existential uncertainty in the patient cancer experience from other, related aspects of uncertainty in the context of an existing framework of health-related uncertainty. Methods In-depth interviews were carried out with six people living with cancer and analyzed using theory-driven, concept-focused thematic analysis. Results Our analysis suggests that existential uncertainty is concerned with meaning rather than information; with the person rather than the disease; and with the fundamental nature of our human being-in-the-world rather than the more practical aspects of our relationships with others. Patient expressions of existential uncertainty may involve a nonscientific discourse of metaphor, analogy, and imagination. Significance of results It is important for professionals working in supportive oncology to have a conceptual understanding of uncertainty in order to choose how best to respond to patients’ needs, as different interventions may be more or less appropriate to different aspects of patient uncertainty.
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