Discussion NT W2 Reply 2: In 1988, researcher Merle Mishel... | Nursing

Clinical Requirement:

In 1988, researcher Merle Mishel developed the Uncertainty in Illness Theory (UIT), which focuses on the experience of uncertainty that patients face when managing an illness. What is uncertainty in this context? Well, it is defined as the inability to determine the meaning of health-related events, which generates stress and hinders decision-making (Reinken & Reed, 2021). UIT identifies factors such as lack of clear information, unpredictability of symptoms, and ambiguity of medical outcomes as uncertainty triggers (Reinken & Reed, 2021). In 1990, Mishel reconceptualized the Theory above and thus emerged the Reconceptualized Uncertainty in Illness Theory (RUIT), which reframes uncertainty not only as a negative experience but also as an opportunity for adaptation (Eppel et al., 2024). In that way, uncertainty can be managed and accepted as an inherent part of the health experience, allowing patients to find new ways to cope with their conditions. Both theories recognize that uncertainty affects patients' understanding of their condition and ability to make decisions and cope with illness. The UIT, in defining uncertainty as a negative experience arising from ambiguity, inconsistency or lack of information about the disease, emphasizes the healthcare professional's role in reducing this uncertainty. This is achieved by providing clear information, ensuring patients understand their diagnosis and treatment, and establishing open communication. This approach contributes to patients feeling more empowered and able to manage their health, promoting care that focuses more on their needs and concerns (Reinken & Reed, 2021). RUIT reconceptualizes uncertainty as an experience that, although initially destabilizing, can also become an opportunity for personal growth and adaptation (Eppel et al., 2024). From this perspective, caregiving involves helping patients accept uncertainty as an inevitable part of the healthcare experience, especially in chronic or long-term illnesses (Eppel et al., 2024). Healthcare providers can encourage adaptive coping strategies, such as seeking social support, developing emotional resilience, and accepting uncertainty so that patients find a sense of control (Eppel et al., 2024). In practice, I have seen the application of this Theory. In acute health cases, uncertainty is standard in patients facing sudden diagnoses such as a myocardial infarction or cerebral hemorrhage. For example, a patient arriving in the emergency room with chest pain may experience profound uncertainty about his or her diagnosis and prognosis. Therefore, our role should be to provide clear explanations of procedures, maintain constant communication, and empathize with their concerns. I have also observed that, in chronic health situations, uncertainty tends to be more prolonged and focused on the unpredictability of symptoms, disease progression, and its impact on quality of life. An example would be a patient with multiple sclerosis facing unpredictable relapses. His case involves encouraging patient education, establishing support networks, and promoting coping strategies that allow acceptance of the nature of his or her condition. References Eppel, J., Kobleder, A., & Mayer, H. (2024). Refining Mishel's Reconceptualized Uncertainty in Illness Theory: Explaining the development of uncertainty in chronic illness. Research & Theory for Nursing Practice, 38(2). https://doi.org/10.1891/RTNP-2023-0068 Reinken, D. N., & Reed, S. M. (2023). Mishel's uncertainty in illness theory: Informing nursing diagnoses and care planning. International Journal of Nursing Knowledge, 34(4), 316-324. https://doi.org/10.1111/2047-3095.12406