A concept analysis of family caregivers’ uncertainty of patient's illness

Abstract

Aim To analyze and examine the concept of uncertainty of the patient's illness among family caregivers. Background Promoting family caregivers’ health is significant in nursing. Family caregivers may experience uncertainty related to their loved ones’ illness. A lack of clarity exists regarding the uncertainty concept among family caregivers and its implications in nursing. Data Source A review of the literature that focused on family caregivers of adult patients using PubMed, CINAHL, and Scopus databases was completed. Methods The Walker and Avant framework was applied to identify the attributes, antecedents, and consequences of family caregivers’ uncertainty. Results Eight articles were analyzed. Attributes of family caregivers’ uncertainty included the patient's illness probability and family caregivers’ perception of the illness. Antecedents included the characteristics of the patient's illness, factors associated with the family caregivers’ perception of the illness, and family responsibilities of caregiving. The consequences included family caregivers’ emotional, psychological, and financial outcomes. Family caregivers’ uncertainty is defined as the perception of the inability to process information regarding the patient's illness trajectory when caring for significant others’ illness. Conclusions Individuals can perceive uncertainty differently as a patient‐facing uncertainty in illness versus a family caregiver facing uncertainty of their loved ones’ illness.

The Mediating Effect of Uncertainty in Illness on Cancer Coping in Patients With Primary Malignant Brain Tumors

“…The sources of social support were defined in this study as both formal and informal caregivers, friends, and family. Patients and caregivers both make treatment and care decisions, and caregivers also experience UI during the cancer process 49 . Caregivers need to be considered as a source of social support for patients with PMBT and a significant factor in the dyadic relationship.…”

“…Patients and caregivers both make treatment and care decisions, and caregivers also experience UI during the cancer process. 49 Caregivers need to be considered as a source of social support for patients with PMBT and a significant factor in the dyadic relationship. Oncology nurses should…”

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“…The PPUS-FM has been used extensively, including family caregiver populations. 12 Reliability among 50 family caregivers of patients with heart failure resulted in strong internal consistency (Cronbach α = 0.89). 13…”

“…Uncertainty among family caregivers is defined as the family caregivers' perception of the inability to process information regarding the patient's illness trajectory during caregiving. 12 The Mishel Uncertainty in Illness Scale-Family Member (PPUS-FM) instrument is a 31-item measure of uncertainty in 4 domains: ambiguity, lack of clarity, lack of information, and unpredictability of illness. 22 Examples of the uncertainty domains are "I am unsure if his/her illness is getting better or worse," reflecting the ambiguity; "The explanations they give about him/her seem hazy to me," reflecting the lack of clarity; "I don't know what is wrong with him/her," reflecting the lack of information; and "I can predict how long his/her illness will last," reflecting the reverse statement of the unpredictability.…”

“…22 Answering uncertainty questions could reflect characteristics of the caregiver's view of the patient's illness. 12 The characteristics of ICU delirium in relation to uncertainty could be explained by other studies, as family caregivers have experienced uncertainty regarding acute changes in patient status-such as fear, agitation, disorientation, and perceptual distortions associated with delirium-that could reflect ambiguity about delirium. 26 Families were uncertain about the patient's recovery from delirium and the consequences of delirium, which could indicate unpredictability of delirium prognosis.…”