Uncertainty in illness among people with mental ill health: a nursing perspective

Abstract

Background/Aims: Uncertainty in illness is a well-known concept in health care literature. A considerable volume of research has investigated how people adapt to different health conditions and how the concept of uncertainty in illness relates to those populations. The aim of this article is to explore the concept of uncertainty in illness among mental health nurses and to provide an understanding of its relevance to people living with mental ill health. Method: A focus group was conducted with mental health nurses at an international psychiatric nursing conference. The focus group discussion was recorded and then transcribed and thematically analysed. Results: Uncertainty in illness among people living with mental ill health exists and manifests itself in various ways: uncertainty in the context of loss, uncertainty as a stimulus for change, and uncertainty as an integral part of the human experience and existence. Conclusions: Even though contemporary approaches in mental health nursing do not directly address uncertainty, the concept and its implications need to be considered and raised further among mental health professionals in order to improve support for people living with mental ill health in their process of personal recovery.

Uncertainty in illness among individuals with schizophrenia: a phenomenology study in Indonesia

“…According to Mishel, individuals may be occupied with uncertainty, ambiguity or confusion regarding their illness (symptoms, cause, course or treatment). Those uncertainties are the main variables among individuals with schizophrenia (Baier, 1995; Wolfensberger et al , 2019; Taş Bora and Buldukoğlu, 2020). Our study revealed a wide range of perspectives on uncertainty in illness among individuals with schizophrenia living in the community in Indonesia.…”

“…Many factors affect the long recovery process in individuals with schizophrenia, including the duration of illness, the severity of symptoms, stigma, discrimination, poor compliance with antipsychotic medication, relapse, lack of social support, lack of understanding of the illness, cognition impairment, substance use disorders, medication effects, unemployment and low family economic status (Tsang and Chen, 2007;Tan et al, 2014;Zipursky, 2014;Padgett et al, 2016;Nowak et al, 2017;Vita and Barlati, 2018;Singla et al, 2020). On the other hand, several other recent studies revealed positive outcomes of schizophrenia treatment, especially those with adequate social support, perceived higher levels of emotional support and perceived higher satisfactory levels of recovery (Buonocore et al, 2018;Wolfensberger et al, 2019;El-monshed and Amr, 2020). Thus, it could be concluded that schizophrenia can be cured, even if it takes a long time.…”

“…At the same time, she also expressed difficulties providing care for the patients (Taş Bora and Buldukoğlu, 2020). Then, when those uncertainties were examined from the nurses’ perspective, it was discovered that patients with mental illness experienced uncertainties in various ways (Wolfensberger et al , 2019). Therefore, nurses need to acknowledge the uncertainty in the illness of individuals with schizophrenia, its impact on their quality of life and how they cope with their illness.…”

Effectiveness of an Uncertainty Management Psychoeducation Program for Schizophrenia Caregivers: A Randomized Controlled Trial

“…In a study investigating the concept of uncertainty in illness among mental health nurses, nurses suggested that recognizing uncertainty and supporting service users in coping with it could be a precious intervention that mental health nurses can provide. However, mental health professionals need to be more aware of the “uncertainty in illness” concept (Wolfensberger et al, 2019).…”