The illness uncertainty concept: A review

Abstract

Illness uncertainty is present for both acute and chronic illnesses and has been described in the literature as a cognitive stressor, a sense of loss of control, and a perceptual state of doubt that changes over time. Illness uncertainty is associated with poor adjustment, but often needs to be appraised as a threat to have its deleterious effect. In pain populations, illness uncertainty is related to heightened sensitivity to pain and reduced tolerance of painful stimuli. Illness uncertainty also has been related to maladaptive coping, higher psychological distress, and reduced quality of life. The illness uncertainty literature in relation to pain is somewhat limited but clearly suggests the potential negative impact on the perception of and adjustment to pain. Future research should examine specific predictors of illness uncertainty, how this construct changes over time, and what interventions may be effective in reducing illness uncertainty for individuals who experience pain conditions.

“It´s incredible how much I´ve had to fight.” Negotiating medical uncertainty in clinical encounters

“…When their ability to identify, explain and treat patients’ ailments is constrained by an uncertain biomedical foundation, they often feel powerless, inadequate, dissatisfied, frustrated and anxious (Åsbring & Närvänen, 2003; Chew-Graham, Cahill, Dowrick, Wearden, & Peters, 2008; Chew-Graham, Dowrick, Wearden, Richardson, & Peters, 2010; Howman, Walters, Rosenthal, Ajjawi, & Buszewicz, 2016; Libert et al, 2016; Murray, Toussaint, Althaus, & Löwe, 2016). For patients, experiences of uncertainty can increase psychological distress, intensify sensitivity to pain (Rosendal et al, 2013; Taylor, Marshall, Mann, & Goldberg, 2012; Weiland et al, 2012; Wright, Afari, & Zautra, 2009), and result in poorer health (Neville, 2003), reduced quality of life and diminished confidence (Ogden et al, 2002). …”

Patient hopes for diagnostic genomic sequencing: roles of uncertainty and social status

“…12,13 Such barriers posed by illness uncertainty may increase patient motivation to learn more information from sequencing results. In addition, people's perceptions of their social and economic resources could shape their views of genomic sequencing and its health implications.…”

Review of Regulatory Programs and New Opioid Technologies in Chronic Pain Management: Balancing the Risk of Medication Abuse with Medical Need

“…Nonetheless, in spite of the findings from newer technologies, it should be noted that there is usually a significant psychiatric comorbidity (e.g., depression, anxiety) found in patients with chronic pain. 12,13 At the present time, the preponderance of the evidence indicates that the psychiatric comorbidity may be a result of the pain rather than its cause, since in most cases, psychiatric comorbidity follows pain development. 12,13 However, generally the presence of psychiatric comorbidity, whatever its cause, complicates pain treatment.…”