Uncertainty and the Duration of Disease in Adults with Type 1 Diabetes

Abstract

Objective: The purpose of this study was to investigate the relationship between type 1 diabetes duration and uncertainty. According to the Reconceptualized Uncertainty in Illness Theory, it was hypothesized that longer duration would be associated with less uncertainty. Research Design and Method: A sample of 379 people with type 1 diabetes recruited from the T1D Exchange completed an online survey. The online survey measured disease duration, uncertainty, and demographic characteristics. Multiple variable linear regression was calculated to test for an association between diabetes duration (in years) and uncertainty in diabetes self-management. Post hoc one-way analysis of variance with Tukey's HSD test was calculated to investigate uncertainty at five and ten-year disease duration intervals. Results: With adjustment for age, gender, and education, diabetes duration was negatively associated with uncertainty (b =-0.15, p = .03; 95% CI =-0.28,-0.01). Uncertainty was lowest among the 64 participants with a duration equal to or greater than 40 years (M=63.53, SD=15.04). In Tukey's HSD post hoc test, the mean difference on the uncertainty scores for 5 to < 10 years diabetes duration (n=38, M=72.66, SD=14.51) and 40 or more years diabetes duration was significant (p = 0.02, 95% CI = 0.81, 17.44). Conclusions: Individuals with longer disease duration reported less uncertainty related to self-management, and uncertainty varied by duration interval. These findings provide preliminary information about where to place behavioral interventions designed to reduce uncertainty among individuals with type 1 diabetes.

Stress Adaptation Model For Uncertain Process Of Diabetes Mellitus Disease

“…Uncertainty in DM clients occurs when individuals cannot assign definite values to events due to lack of signs and information. Uncertainty according to Mishel (1983) is a novelty, complexity, ambiguity, and unexpected lack of information (Acuff and Jabson, 2016). This can be seen in this study which shows that clients who have good cognitive abilities have the ability to access information about the disease so that they are able to minimize the state of uncertainty in themselves.…”

“…According to the reconceptualized theory of uncertainty in disease, a longer duration of Diabetes Mellitus should be associated with less uncertainty as individuals are perceived to become more skilled in chronic disease self-management. The study conducted (Acuff and Jabson, 2016) found differences in uncertainty at different duration intervals. In this study, uncertainty increased 5 to <10 years after diagnosis, decreased and then persisted between 10 to <40 years.…”