Uncertainty in illness and coping behavior in patients with various somatic diseases

The article describes the results of a study conducted to assess the characteristics of uncertainty in illness and coping behavior, as well as their relationship, in patients with various somatic diseases. The study included 247 patients with cancer and 52 patients with cardiovascular diseases (CVD). The main research methods were socio-demographic and clinical questionnaires, the Mishel Illness Uncertainty Scale (adult form), the COPE Inventory, the Method for Assessing Self-Efficacy in Treatment, the Multidimensional Scale of Perception of Social Support and the Beck Depression and Anxiety Inventories. It was found that uncertainty in illness in patients with cancer is higher than in the CVD group. Both groups of patients predominantly use adaptive coping strategies. Patients with cancer more often use strategies of acceptance and mental disengagement to cope with stress, and the CVD group uses the strategy of restraint. The assessment of social support perceived by CVD is higher compared to the cancer patients. Self-efficacy in treatment and anxiety indicators do not differ between the groups, while the level of depression is significantly higher in patients with cancer compared to the CVD group. Uncertainty in illness is associated with coping strategies of patients with cancer and CVD, while there are similar patterns and differences in the studied groups. A negative relationship between uncertainty in illness and perception of social support, as well as self-efficacy in treatment, was found only in the group of patients with cancer. In the same group of patients, uncertainty in illness is positively associated with anxiety. Indicators of depression and uncertainty in illness are positively associated in both groups of patients with somatic diseases.

1. Mishel M.H. Uncertainty in illness. Journal of Nursing scholarship. 1988; 20(4): 225-232. doi:10.1111/j.1547-5069.1988.tb00082.x

2. Verduzco-Aguirre H.C., Babu D., Mohile S.G., Bautista J., Xu H., Culakova E., Canin B., Zhang Y., Wells M., Epstein R.M., Duberstein P., McHugh C., Dale W., Conlin A., Bearden J., Berenberg J., Tejani M., Loh K.P. Associations of Uncertainty With Psychological Health and Quality of Life in Older Adults With Advanced Cancer. Journal of Pain and Symptom Management. 2020; 61(2):369-376. doi:10.1016/j.jpainsymman.2020.08.012

3. Xia B., Yu J., Wu X. Illness uncertainty and its associated factors in coronary heart disease patients with heart stent implantation: a cross-sectional study. 2022;11(7):2410-2421. 10.21037/apm-22-528

4. Han Z.T., Zhang H.M., Wang Y.M., Zhu S.S., Wang D.Y. Uncertainty in illness and coping styles: Moderating and mediating effects of resilience in stroke patients. World journal of clinical cases. 2021;9(30):8999-9010. doi: 10.12998/wjcc.v9. i30.8999

5. Mishel M.H. Reconceptualization of the uncertainty in illness theory. Journal of Nursing Scholarship. 1990; 22(4): 256-262. doi:10.1111/j.1547-5069.1990.tb00225.x

6. Holahan C.J., Moos R.H., Groesz L.M. Community Studies. Encyclopedia of Stress (Second Edition). Ed. G. Fink, Academic Press, 2007: 536-541. Available at: https://doi.org/10.1016/B978-012373947-6.00089-1 (accessed 13 November 2024).

7. Lazarus R.S., Folkman S. Stress, Appraisal, and Coping. NY: Springer, 1984. 436 p.

8. Endler N. S., Parker J.D. Multidimensional assessment of coping: A critical evaluation. Journal of Personality and Social Psychology. 1990; 58(5): 844-854.

9. Li W., Fangfang Z., Mengyun P., Hong G. The mediating effect of coping adaptability on the relationship between uncertainty and psychological stress response in patients under observation in the emergrncy department. Chinese Journal of Practical Nursing. 2020; 36(11):855-860. doi:10.3760/cma.j.cn211501-20191029-03088

10. Mishel M.H. The measurement of uncertainty in illness. Nursing Research. 1981; 30(5):258-263.

11. Rasskazova E.I., Gordeeva T.O., Osin E.N. Koping-strategii v strukture deiatel’nosti i samoreguliatsii: psikhometricheskie kharakteristiki i vozmozhnosti primeneniia metodiki Cope. Psikhologiia. Zhurnal Vysshei shkoly ekonomiki 2013; 10(1):82—118. (in Russian). Available at: https://cyberleninka.ru/article/n/koping-strategii-v-strukture-deyatelnosti-i-samoregulyatsii-psihometricheskie-harakteristiki-i-vozmozhnosti-primeneniya-metodiki-cope (accessed 13 November 2024).

12. Rasskazova E.I., Thostov A.Sh. Aprobacija metodik diagnostiki lokusa kontrolja prichin bolezni i lechenija i samojeffektivnosti v otnoshenii lechenija. Vestnik JuUrGU. Serija «Psihologija».2016; 9(1): 71-83. doi:10.14529/psy160108 (in Russian).

13. Sirota N.A. Koping - povedenie v podrostkovom vozraste. Diss. dokt. med. nauk. Bishkek – Saint-Petersburg, 1994. (in Russian).

14. Tarabrina N.V. Praktikum po psihologii posttravmaticheskogo stressa [Workshop on psychology of post-traumatic stress]. SPb.: Piter. 2001. 272 p. (in Russian).

15. Beck A.T., Steer R.A. Beck Anxiety Inventory manual. San Antonio, TX: Psychological Corporation, 1993. 23 p.

16. Mishel M.H., Epstein D. Uncertainty in Illness Scales Manual. Chapel Hill, NC: University of North Carolina, 1997.

17. Pogosova N.V., Bojcov S.A., Oganov R.G., Yufereva YU.M., Kostyuk G.P., Kursakov A.A., Ausheva A.K., Vygodin V.A. ot imeni issledovatelej 30 rossijskikh centrov. Kliniko-ehpidemIOlogicheskaya prograMma izuchEniya psikhosocial'nykh fakTorov riskA v kardiologicheskoj praktike u bol'nykh arterial'noj gipertoniej i ishemicheskoj bolezn'yu serdca (KOMETA): pervye rezul'taty rossijskogo mnogocentrovogo issledovaniya. Kardiologiya. 2018;58(9):47–58. doi:10.18087/cardio.2018.9.10171 (in Russian).

18. Guan T., Chapman M.V., Zerden L. de S., Sharma A., Chen D.-G., Song L. Correlates of illness uncertainty in cancer survivors and family caregivers: a systematic review and meta‑analysis. Supportive Care in Cancer. 2023; 31(4):242. doi:10.1007/s00520-023-07705-7

19. Bailey D.E., Wallace M., Mishel M.H. Watching, waiting and uncertainty in prostate cancer. Journal of Clinical Nursing. 2007;16(4): 734–741. doi:10.1111/j.1365-2702.2005. 01545.x

20. Li X., He L., Wang J., Wang M. Illness uncertainty, social support, and coping mode in hospitalized patients with systemic lupus erythematosus in a hospital in Shaanxi, China. PLOS ONE 2019;14(2): e0211313. doi:10.1371/journal.pone.0211313

21. Wu S., Guo X., Tang H., Li Y., Dong W., Lu G., Hou C. The Relationship Between Illness Uncertainty and Social Support Among Cancer Patients: A Meta-analysis. Cancer Nursing. 2024. doi:10.1097/NCC.0000000000001328

22. Jeong H., Lee Y., Park J.S., Lee Y. Influence of Illness Uncertainty on Health Behavior in Individuals with Coronary Artery Disease: A Path Analysis. Journal of Korean Academy of Nursing. 2024;54(2):162-177. doi:10.4040/jkan.23136

23. Choi D., Shin H. The effect of illness uncertainty and self-efficacy on the perception of shared decision-making among parents of infants in the neonatal intensive care unit. Nursing in Critical Care. 2024; 1:1-10. doi:10.1111/nicc.13154.

24. McCormick K.M., Naimark B.J., Tate R.B. Uncertainty, symptom distress, anxiety, and functional status in patients awaiting coronary artery bypass surgery. Heart & Lung: The Journal of Acute and Critical Care. 2006; 35(1): 34–45. doi: 10.1016/j.hrtlng.2005.08.002

25. Stark D., Kiely M., Smith A., Velikova G., House A., Selby P. Anxiety Disorders in Cancer Patients: Their Nature, Associations, and Relation to Quality of Life. Journal of clinical oncology. 2002; 20(14):3137-3148. doi:10.1200/JCO.2002.08.549

26. Kang H.-Y., Choi E.-Y. Factors Influencing Quality of Life in Patients with Multiple Myeloma. Contemporary Nurse. 2019;55(2-3):109-121. doi: 10.1080/10376178.2019.1623699