Mishel’s Uncertainty of Illness Theory is a middle-range theory (Black, 2014). This means the theory is not overly broad or narrow. The theory was developed from studying men with prostate cancer who were watchfully waiting for the advancing signs of their disease (Black, 2014). The theory has three main components, which incorporate: the antecedents of uncertainty, impaired cognitive appraisal, and coping with uncertainty in illness (Neville, 2003). The antecedents of Mishel’s theory are the stimulus frame, cognitive capacities and event congruence (Neville, 2003). The stimulus frame concerns three parts including: symptom pattern, event familiarity and event congruency (Neville, 2003). Symptom pattern may be when symptoms of illness present with consistency to form a pattern (Elphee, 2008). Event familiarity refers to the repetitive nature of the healthcare environment and not necessarily the physical characteristics of the disease (Elphee, 2008). Elphee also defines event congruence as the correlation between what is expected and what actually is experienced.
According to Kathleen Neville, there are two variables that may influence Mishel’s stimulus frame: cognitive capacity and structure providers. Cognitive capacity may be affected or impaired because of multiple factors the patient experiences. As stated by Neville, cognitive capacity may be affected by difficulty processing information due to anxiety, fatigue, drugs and chemotherapy. Structure providers are defined by Neville on page 208 as, “the resources available to assist an individual,” such as the person’s social support and educational level.
Mishel views uncertainty as a danger or an opportunity (Neville, 2003)
Merle Mishel developed a way to measure...
... middle of paper ...
Positive nursing intervention may be applied for future practice. Nurses fit into Mishel’s model in that they are the structure providers. The nurse must be able to guide the patient toward positive coping mechanisms, that way, to better the patient outcomes. Nurses may help a patient struggling with a new troubling diagnosis adapt to their new illness by explaining the symptoms and processes of the disease. This may eliminate the thoughts of uncertainty that may be brought about in such a negative and frightening situation. Suzuki pointed out that “patients with cancer are more satisfied with health care when their perception of their involvement in decision making matches their desire to be involved in decision making.” This means it is important for the nurse to make sure the patient is involved in a majority of the care and healing process in a positive way.
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