Uncertainty expression in surgical patients of organ removal: a cross-sectional study
Abstract
Introduction: The surgical treatment of organ removal seems to meet a number of pathologies that emerge as health needs of populations. In this context, the state of uncertainty is installed.
Objective: To investigate the uncertainty in illness in surgical patients of organ removal.
Method: Cross-sectional study developed with patients admitted to the surgical outpatient clinic of a university hospital. Sociodemographic and clinical variables were collected, in addition to applying Mishel uncertainty in illness scale.
Results: The profile of medical diagnoses in the 60 participants showed that the most frequent diseases were the neoplasms. As for the scale application, 68% of the participants presented scores greater than or equal to 80 points. The value found for the Cronbach’s Alpha was 0.842. The surgical procedures abdominal hysterectomy and mastectomy, which were the most prevalent for the participants, are associated with uncertainty domains.
Conclusions: High levels of uncertainty demonstrated the need for the management of this condition. The psychosocial aspects of surgical treatments are disregarded at the expense of the clinical restoration, circumstances that neglect the patient’s emotional suffering. The improvement of communication between the health professional and the patient can influence to prevent the manifestation of the lack of information, one of the forms of expressing uncertainty. Aspects such as the patient’s socioeconomic profile, educational level and income must be taken into account in the surgical treatment of organ removal. The uncertainty experienced by these patients needs to be better known and widely disseminated to gain prominence in the health care setting.
Downloads
References
Lee I-M, Shiroma EJ, Lobelo F, Puska P, Blair SN, Katzmarzyk PT. Impact of Physical Inactivity on the World's Major Non-Communicable Diseases. Lancet [Internet]. July 21, 2012 [cited June 14, 2020];380(9838):219-29. Available from: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3645500/
Carvalho R de, Bianchi ERF. Enfermagem em Centro Cirúrgico e Recuperação. In: Enfermagem em centro cirúrgico e recuperação. Barueri: Manole; 2016.
Gonçalves TF, Medeiros VCC. The preoperative visit as the anxiety mitigating factor in surgical patients. Rev. SOBECC, São Paulo. 2016; 21(1):22-7. Available from: https://sobecc.emnuvens.com.br/sobecc/article/view/38/pdf. DOI: 10.5327/Z1414-4425201600010004.
Oliveira TR, Souza JR. Avaliação do impacto psicossocial do diagnóstico e tratamento do câncer na vida de familiares cuidadores de pacientes em regime de internação hospitalar. Tempus, Actas Saúde Colet, Brasília. 2017 Mar;11(1), 215-227. Available from: http://docs.bvsalud.org/biblioref/2018/03/880750/lgbt-11-portug.pdf DOI: https://doi.org/10.18569/tempus.v11i1.2228
Santos MMB dos, Martins JCA, Oliveira LMN. A ansiedade, depressão e stresse no pré-operatório do doente cirúrgico. Rev. Enf. Ref. [Internet]. 2014; serIV(3):7-15. Available from: https://rr.esenfc.pt/rr/index.php?module=rr&target=publicationDetails&pesquisa=&id_artigo=2461&id_revista=24&id_edicao=68
Mishel MH. Uncertainty in Illness. Image: the Journal of Nursing Scholarship [Internet]. 1988 [cited June 14, 2020];20(4):225-32. Available from: https://sigmapubs.onlinelibrary.wiley.com/doi/abs/10.1111/j.1547-5069.1988.tb00082.x
Hagen KB, Aas T, Lode K, Gjerde J, Lien E, Kvaløy JT, et al. Illness uncertainty in breast cancer patients: Validation of the 5-item short form of the Mishel Uncertainty in Illness Scale. European Journal of Oncology Nursing 2015;19(2):113–19. https://doi.org/10.1016/j.ejon.2014.10.009
Giammanco MD, Gitto L, Barberis N, Santoro D. Adaptation of the Mishel Uncertainty of Illness Scale (MUIS) for chronic patients in Italy. Journal of Evaluation in Clinical Practice 2015;21(4):649–55. doi:10.1111/jep.12359
Hall DL, Mishel MH, Germino BB. Living with cancer-related uncertainty: associations with fatigue, insomnia, and affect in younger breast cancer survivors. Support Care Cancer [Internet]. April 12, 2014 [cited June 14, 2020];22(9):2489-95. Available at: https://europepmc.org/article/med/24728586?client=bot
McEwen M. Visão Geral de algumas teorias de enfermagem de médio alcance. Em: McEwen M, Wills EM, editores. Bases teóricas de enfermagem, Porto Alegre: Artmed; 2016, p. 246-54.
Mishel MH. The measurement of uncertainty in illness. Nursing Research 1981;30(5):258–63. https://doi.org/10.1097/00006199-198109000-00002
Barbosa IV. Tradução, adaptação e validação da Mishel Uncertainty in Illness Scale for Family Members: aplicação em familiares de pessoas com paraplegia. Fortaleza. Tese [Doutorado em Enfermagem] - Faculdade de Farmácia, Odontologia e Enfermagem da Universidade Federal do Ceará; 2012. Available from: http://www.repositorio.ufc.br/handle/riufc/15629.
Brasil. Ministério da Saúde. Brasil. Instituto Nacional do Câncer José Alencar Gomes da Silva. Coordenação de Prevenção e Vigilância. Estimativa 2020: Incidência de Câncer no Brasil. Rio de Janeiro; 2019. Available from: https://www.inca.gov.br/sites/ufu.sti.inca.local/files//media/document//estimativa-2020-incidencia-de-cancer-no-brasil.pdf. ISBN 978-85-7318-389-4.
Bolívar Montes LA, Montalvo A. Uncertainty associated to parents of preterm infants hospitalized in neonatal intensive care units. Investigación y Educación en Enfermería, 2016;34(2):360-67. http://dx.doi.org/10.17533/udea.iee.v34n2a16.
Aldaz BE, Hegarty RSM, Conner TS, Perez D, Treharne GJ. Is avoidance of illness uncertainty associated with distress during oncology treatment? A daily diary study. Psychol Health. 2019 Apr;34(4):422-437. doi: 10.1080/08870446.2018.1532511. Epub 2019 Jan 4.
Mishel MH, Clayton M. Theories of uncertainty in illness. In: Smith MJ, Liehr PR (Eds.). Middle range theory for nursing. 2nd ed. New York: Springer; 2008.
Jeon BH, Choi M, Lee J, Noh SH. Relationships between gastrointestinal symptoms, uncertainty, and perceived recovery in patients with gastric cancer after gastrectomy. Nursing & Health Sciences. 2016;18:23–29. Doi: 10.1111/nhs.12219
Torres-Ortega C, Peña-Amaro P. Adaptación cultural de la escala de incertidumbre de Mishel en el paciente tratado con hemodiálises. Enfermería Clínica 2015;25(1):9-18. DOI: 10.1016/j.enfcli.2014.09.002
Oliveira TMG de, Jesus CAC de. Incertezas vivenciadas por pacientes pós-cirúrgicos diagnosticados com neoplasias. Rev enferm UFPE on line, 2018 out;12(10):2873-82. Available from: https://pubmed.ncbi.nlm.nih.gov/26713368/
Kuang K, Wilson SR. A Meta-Analysis of Uncertainty and Information Management in Illness Contexts. Journal of Communication, 2017;67(3):378-401. doi:10.1111/jcom.12299.
Barbosa ARS, Santos AN, Rodrigues TS. Experiência de mulheres que realizaram histerectomia: revisão integrativa. Revista Uningá. 2018; 55(2):227-41. Available from: http://34.233.57.254/index.php/uninga/article/view/2202
Teixeira MR, Batista EC. Vivências Cotidianas da Mulher Histerectomizada: Narrativas e Contextos. Rev. Enfermagem e Saúde Coletiva. 2016; 1(2):91-107. Available from: https://www.researchgate.net/publication/320935572_Vivencias_Cotidianas_da_Mulher_Histerectomizada_Narrativas_e_Contextos_Daily_Lives_of_Hysterectomized_Woman_Narratives_And_Contexts. ISSN: 2448-394X.
Hilton BA. The relationships of uncertainty, control, commitment, and threat of recurrence to coping strategies used by women diagnosed with breast cancer. J Behav Med. 1989;12(1):39-54. DOI: 10.1007/bf00844748
Pahlevan SS, Ahadzadeh AS, Perdamen HK. Uncertainty and quality of life of Malaysian women with breast cancer: Mediating role of coping styles and mood states. Applied Nursing Research 2017;38:88–94. doi: 10.1016/j.apnr.2017.09.012
Viana DDA, Santana CCC de, Souza JRS. Análise das ações de enfermagem nas fases cirúrgicas da mastectomia. Revista Brasileira De Inovação Tecnológica Em Saúde. 2018;8(2):67-82. https://doi.org/10.18816/r-bits.v8i2.15556
Takeshita IM, Araujo IEM. Communication strategies and interaction of the patient with the unconscious patient. Reme - Rev. Min. Enferm. 2011;15(3): 313-323. Avaliable from: http://www.reme.org.br/artigo/detalhes/40
Gonçalves MAR, Cerejo MNR; Martins JCA. A influência da informação fornecida pelos enfermeiros sobre a ansiedade pré-operatória. Referencia 2017; IV(14): 17-26. Available from: http://www.index-f.com/referencia/2017/414017.php
Gómez-Palencia IP, Castillo-Ávila IY, Alvis-Estrada LR. Incertidumbre en adultos diabéticos tipo 2 a partir de la teoría de Merle Mishel. Aquichan [Internet]. 2015 Apr [cited 2020 Oct 26]; 15(2):210-218. http://dx.doi.org/10.5294/aqui.2015.15.2.5.
Davison BJ, Goldenberg SL. Decisional regret and quality of life after participating in medical decision-making for early-stage prostate cancer. BJU International [Internet]. 2003 [cited 2020 Oct 26];91(1):14-7. Available from: https://bjui-journals.onlinelibrary.wiley.com/doi/abs/10.1046/j.1464-410X.2003.04005.x doi: 10.1046/j.1464-410x.2003.04005.x.
Bailey Jr D, Stewart JL. Teoría de la incertidumbre frente a la enfermedad. In: Alligood MR, Tomey AM, editors. Modelos y teorías en enfermeira 7. ed, Madrid: España: Elsevier Science; 2011. 599-617.
The works published in this magazine are subject to the following terms:
1. The Publications Service of the University of Murcia (the publisher) preserves the copyright of the published works, and encourages and allows the reuse of the works under the license for use stated in point 2.
© Servicio de Publicaciones, Universidad de Murcia, 2011 (© Publications Service, University of Murcia, 2011)
2. The works are published in the electronic edition of the journal under Creative Commons Reconocimiento-NoComercial-SinObraDerivada 3.0 España(texto legal) “ a Attribution-NonCommercial-NoDerivatives 3.0 Spain license (legal text)”. They can be copied, used, broadcasted, transmitted and publicly displayed, provided that: i) the authorship and original source of their publication (journal, publisher and URL) are cited; (ii) are not used for commercial purposes; iii) the existence and specifications of this license is mentioned.
3. Conditions of self-archiving. Authors are allowed and encouraged to electronically disseminate the pre-print (pre-reviewed ) and / or post-print (reviewed and accepted for publication) versions of their works prior to publication, as it ensures a wider circulation and dissemination which may lead to a possible increase in its mention and a higher scope among the academic community. RoMEO color: green.