(Mishel, 1988, as cite in Neville, 2003) define uncertainty in illness as the inability to determine the meaning of illness-related events, assign definite values to objects and events, and/or accurately predict outcomes. Mast (2006) says there are four factors that represent aspects of uncertainty and include: ambiguity, complexity, inconsistency, and unpredictability. Mast (2006) emphasizes that when a patient receives information about an illness that is representative of any of these four factors, uncertainty about their illness is more likely to occur. McCormick (2002) states that uncertainty is a major component of the illness experience and can dramatically affect psychosocial adaptation and outcomes of disease. Uncertainty is usually perceived as an adverse event, often being associated with negative psychosocial outcomes, such as emotional or psychological distress, anxiety, and depression (Neville, 2003). However, Mishel and Clayton (2008) say that uncertainty should reflect a neutral state and should not be associated with emotions until evaluated.
The uncertainty theory was developed to explain how uncertainty develops in patients with an acute illness and proposes how a patient should deal with uncertainty (Mishel, 2006). The theory of uncertainty in illness is composed of three major themes: (1) antecedents of uncertainty, (2) appraisal of uncertainty, and (3) coping with uncertainty (Mishel & Clayton, 2008).
Themes in Uncertainty in Illness