Using the uncertainty in illness theory to provide care for the caregiver: A case report

Abstract

Mishel’s Theory of Uncertainty in Illness (1988-1990) explains how patients and caregivers interpret the uncertainty about the course of an illness. Additionally, it provides a framework for selecting of interventions that will improve the psychological and behavioral outcomes of uncertainty. This manuscript provides an example of the care provided to a caregiver of an individual with schizophrenia based on Mishel’s Theory of Uncertainty in Illness. A caregiver referred to as GC is staying with the patient who has been hospitalized at the clinic for one and a half months as her attendant. GC had been providing care for the patient in her home for the last five years and has experienced psychosocial problems. The main concepts of the Theory of Uncertainty in Illness are: antecedents of uncertainty, appraisal of uncertainty and coping with uncertainty. GC’s statements such as “While we were thinking that she was almost well, now we are back to the beginning and I am confused about it” as well as reporting her lack of understanding about the course of the illness shows the uncertainty that she experienced and the antecedents of this uncertainty. The caregiver needed information about the course of the chronic illness and perceived uncertainty as a negative situation. Her crying and feelings of helplessness illustrated she had an emotion-focused coping mechanism. Having knowledge about the situations that create uncertainty in the caregiver, the researcher used the interventions to improve knowledge about the disease, cognitive reframing, problem solving and communication skills in managing uncertainty. The theory is thought to explain the uncertainties caregivers have with managing a patient with schizophrenia. This theory supports the interaction between caregivers and nurses. There are few studies based on UIT in Turkey, therefore further studies are needed to test the UIT.