The Social Environment and Illness Uncertainty in Chronic Obstructive Pulmonary Disease

Abstract

Purpose-Illness uncertainty is associated with worse outcomes in patients with chronic health conditions. Research on social factors associated with uncertainty has focused on the beneficial role of social support. The goal of this study was to develop a more nuanced understanding of the social factors that are associated with uncertainty.

Stigma and illness uncertainty: adding to the burden of sickle cell disease

“…Studies are also needed to understand why women face higher levels of illness uncertainty and gender-specific strategies may need to be developed to reduce the same. Higher levels of social support can mitigate against both stigma [66] and illness uncertainty [22] Family and other personal support networks can assist a person to make better sense of their illness; peersupport can assist in coping and undermining their stigma experiences; and structural factors, such as more accessible quality healthcare services can improve patients' healthcare experiences and reduce adverse outcomes.…”

“…Higher scores imply higher levels of illness uncertainty. The scale was developed not only for acutely ill adults but has also been widely used in patients with chronic illnesses, such as breast cancer, hepatitis C, prostate cancer and chronic obstructive pulmonary disease [20,22,32,[36][37][38][39]. The instrument has four subscales: complexity, unpredictability, ambiguity and consistency with coefficient alphas between 0.65 and 0.86 for the subscales and 0.87 for the overall scale.…”

“…The concept of 'illness uncertainty' has been explored both in acute and chronic illnesses [14,15] and Mishel has defined it as the inability to determine the meaning of illness related events [16]. The influence of illness uncertainty has been examined in lifethreatening conditions such as cancer [17][18][19][20], cardiopulmonary conditions [21,22] and HIV [23,24] and is found to be an additional psychosocial stressor on patients [25] and families [26]. Individuals living with SCD and their families may also experience uncertainty in everyday life due to the unpredictability of onset of a painful crisis and unforeseen complications, such as infections or the fear of early death.…”

Informal caregivers of patients with COPD: Home Sweet Home?

“…The social environment encompasses more than social support, including perceived criticism. Therefore, the social environment is complex [29].…”

O ensino da incerteza em Medicina Geral e Familiar

“…One study looked at ambiguity, defined as a lack of understanding of symptoms and complexity, defined as lack of understanding of treatment, in the lives of 462 patients with chronic obstructive lung disease. 7 Criticism from family members increased uncertainty while participation in patient support groups helped patients by decreasing their uncertainty. Research into patient self-help groups and their effects on uncertainty and self-efficacy might be useful in Portugal.…”