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Perceptions of uncertainty in family members of adult intensive care unit patients Miller, Pamela Joan


This descriptive correlational study was designed to determine the level of uncertainty perceived by family members of adult ICU patients. The study investigated the relationship between the perceived level of uncertainty and illness severity. In addition, the study sought to explore family members’ subjective perceptions of factors which were related to uncertainty during the ICU experience. The Mishel (1988) theory of Uncertainty in Illness guided this study. A convenience sample of 30 family members of critically ill ICU patients completed the Family Member Version of the Parents Perception of Uncertainty in Illness Scale (PPUS—FM), the Visual Analogue Scale (VAS) for illness severity, and a demographic information sheet. In addition, 12 of the 30 family members participated in a semi—structured interview. The findings demonstrated wide variability in the family members’ perceived level of uncertainty. However, the majority of family members of ICU patients perceived moderately high levels of uncertainty. The nature of the uncertainty experienced appears to be primarily generated in response to ambiguity and unpredictability of the situation. The relationship between perceived uncertainty and illness severity was not statistically significant. Mishel’s (1988) theory of Uncertainty in Illness supports the possibility that this finding may be a function of the family member’s appraisal of the illness situation. Additional negative correlations, although not statistically significant, were found between the uncertainty factors of lack of clarity and lack of information and severity of illness. This suggests family members’ who receive less information may have a more positive, although not necessarily accurate, appraisal of the illness situation. The guided interviews revealed family members of ICU patients perceive similar uncertainties during the ICU experience. Uncertainty was related to the unpredictable illness or treatment situation, the unfamiliar environment and system of care and changes in family member functioning. The family member functioning theme is not accounted for in the Mishel (1988) framework, and appears to be primarily related to changing roles. Although a number of positive beliefs were used by family members to promote a hopeful outlook, responses indicated that most family members’ appraisal of uncertainty fluctuated between a danger and an opportunity appraisal.

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