N 95 Nursing Care of Persons with Chronic Illness


Segment 1
Defining Illness

Segment 2
Illness Trajectory

Segment 3
Managing Uncertainty

Segment 4

Segment 5

Summary and Assessment





Segment Three: Managing your uncertainty

Our Expert

We are fortunate to have in our very own School of Nursing, the internationally recognized expert on uncertainty in chronic illness: Merle H. Mishel, RN, PhD.

Dr. Mishel has devoted her nursing career to researching how the element of uncertainty does indeed affect persons with chronic illness. She has studied cardiac illnesses, respiratory illnesses, parents of children with epilepsy - and, currently, women with breast cancer and men with prostate cancer. She has now developed an uncertainty management intervention. She has demonstrated that uncertainty can become an opportunity to re-define one's life and self-concept in a positive, healing way. Unfortunately, uncertainty can also be a danger with a high emotional arousal that has deleterious effects.

You will see a synopsis of her work in your required reading article, written by Kim McCormick. Also, in the reference list at the end of this unit, you will find some of Dr. Mishel's original writings, which you may wish to consult further.

You may also have/take the opportunity to contact our star directly @:

Required Reading

At this point, you should read your second required chronic illness article:

McCormick K. M. (2002). A concept analysis of uncertainty in illness. Journal of Nursing Scholarship.34 (2) 127-131. ADD HSL LINK

Uncertainty In Chronic Illness

As you have learned, uncertainty involves the inability to determine the meaning of illness-related events. This inability has been shown to create emotional distress and a decreased sense of well-being (though Mishel argues that, for some people, in some situations, it can be an opportunity for growth.)

There are 6 precipitating characteristics of uncertainty:

  1. ambiguity
  2. inconsistency
  3. vagueness
  4. unpredictability
  5. lack of information
  6. unfamiliarity

As McCormick pointed out, lack of information is the most easily rectified. Make a list of your questions about your chronic illness and its management. Be sure to get answers to your questions at each visit to your health provider.

Discussing Your Uncertainty

You will now discuss your uncertainty about your chronic illness with your peers. You will use the same group with whom you are discussing The Spirit Catches You and You Fall Down.

Use the "group" button on the course home page to go to your group. Click on "discussion forum" and choose the forum "Discussing Your Uncertainly".

In your first posting, tell your peers which chronic illness you gave yourself and address each of the 6 predisposing characteristics of uncertainty. Did you experience any of them? Which ones? What did you do to return to a place of more certainty and well-being?

Respond to each of your peer's postings and make any suggestions about how they may better manage their uncertainty.

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