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Uncertainty over time and its relationship to life satisfaction for biological valve patients Ford, Jo-Ann Elizabeth


This descriptive correlational study was designed to determine the perceived level of uncertainty of individuals who have had a biological cardiac valve implanted. The study investigated the relationship between uncertainty and factors that might influence this uncertainty such as time since implant, age at initial implant, and the relationships between uncertainty and quality of life indicators, such as patients' perceptions of their life satisfaction. The Lazarus and Folkman (1984) cognitive theory of psychological stress and coping guided this study. A convenience sample of 121 subjects who had their first biological valve implanted at least 12 months prior completed the Uncertainty Stress Scale (USS), the Mishel Uncertainty in Illness Scale Community Version (MUISCV), the Cantril Self-Anchoring Scale, and a patient information sheet. The subjects were mailed the questionnaires. Overall, the biological valve patients perceived moderately low levels of uncertainty. The nature of the uncertainty experienced appears to be primarily generated by the patient not being able to foretell the future and by unpredictability in their situation. There was a significant difference in uncertainty depending on the time since implant for subjects grouped according to year of implant. Subjects whose valves were implanted between 1976 and 1978, who had their valves implanted for approximately 11 to 13 years, experienced the lowest level of uncertainty. The highest level of uncertainty was experienced by subjects implanted between 1979 and 1981. Subjects implanted between 1982 and 1984 experienced the second highest level of uncertainty and the second lowest level of uncertainty was experienced by subjects implanted between 1985 and 1987. A significant relationship was not found between uncertainty and the age of a patient at implant. Quality of life indicators of biological valve patients may be adversely influenced by uncertainty. Higher levels of uncertainty are appraised as stressful or threatening and contribute to a poorer past, present, and future life satisfaction and health status. A significant positive relationship was demonstrated between uncertainty and stress. The higher the level of uncertainty, the higher the subjects' overall perceptions of stress. The findings of this study were discussed in relation to other research studies, the theoretical framework, and methodological problems inherent to the study. Implications for nursing practice, theory, and education, and recommendations for future research were identified.

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