A Concept Analysis of Parental Uncertainty in Illness of an Infant

Abstract

Background: The concept of uncertainty in illness has been well described and applied to many different areas of nursing and other disciplines. Specifically, parental uncertainty in illness of an infant is a meaningful concept that has specific attributes and implications. A current concept analysis that considers the changing healthcare setting, historical conceptual inconsistencies, and a lack of information concerning parents of infants is needed. Purpose: To identify essential antecedents, attributes, and consequences of parental uncertainty in illness using Rodgers' Evolutionary Concept Analysis method. Methods: A literature search was conducted using PubMed, CINAHL, and PsycInfo. The following keywords were used in combination using the Boolean terms “AND” and “OR”: parental uncertainty; infants; parental uncertainty in illness; preterm infants; parent; uncertainty. Inclusion criteria: articles published between 2000 and 2017 and published in English. The search included 38 articles published from 2000 to 2017 with a specific focus on parental uncertainty in illness. Findings: Parental uncertainty in illness of an infant is a paradoxical, cognitive, and emotional experience in which there is an inability to create meaning and may cause disruption in parental role development. Implications for Practice: Nursing care of parents with ill infants and children must include sensitivity to parents' experiences of uncertainty in illness. Nurses are uniquely positioned to normalize parental uncertainty and facilitate healthy coping.

Factors influencing caregivers' uncertainty of children undergoing cardiac surgery in Bangkok, Thailand

“…Limited studies conducted on caregivers' uncertainty mostly emphasized the postcardiac surgery period [13] providing a different aspect to precardiac surgery conditions. In order to prevent the negative impacts of caregivers' uncertainty of children undergoing cardiac surgery [10][11][12], this research aimed to study the factors influencing caregivers' uncertainty by using Mishel's uncertainty in illness concept as the theoretical framework [9].…”

“…In addition, cognitive capacity and structure providers, including social support and credible authorities in health-care providers also influence uncertainty [9]. Caregivers' uncertainty has been associated with higher levels of psychological distress such as stress, anxiety or depression [10] and this may develop behaviors similar to post-traumatic stress disorder (PTSD) such as insomnia, nervousness or fatigue [11] that in turn interferes with the caregiver's role and also the caregiver/child relationship [12]. A previous study showed that research regarding caregivers' uncertainty of children in their care with CHD remains underestimated.…”

Uncertainty and perinatal post‐traumatic stress disorder in the neonatal intensive care unit

“…Uncertainty about illness has been theorized to be an antecedent to traumatic stress in parents of sick children (Santacroce, 2003). The uncertainty that parents of sick infants experience is unique as compared to that experienced by parents of older children (Malin & Johnson, 2019). This uncertainty is uniquely associated with both the immediate and long‐term prognosis as well as the complexities of illness and care management needs for which parents become responsible after hospitalization (Malin & Johnson, 2019).…”

“…The uncertainty that parents of sick infants experience is unique as compared to that experienced by parents of older children (Malin & Johnson, 2019). This uncertainty is uniquely associated with both the immediate and long‐term prognosis as well as the complexities of illness and care management needs for which parents become responsible after hospitalization (Malin & Johnson, 2019). These unique needs often prevent parents from creating meaning from their experiences during and after NICU hospitalization (Chaney et al, 2016; Lasiuk et al, 2013).…”

“…These two forms of information management strategies are similar to two of the symptom clusters of post‐traumatic stress disorder: hyperarousal and avoidance (Santacroce, 2003). For parents in the NICU, uncertainty about the health of their infant may disrupt the critical processes of family and parental role attainment (Granrud et al, 2014; Malin & Johnson, 2019; Obas et al, 2016).…”