Haramaya University

College of Health and Medical Sciences

School of Graduate Studies
MSc in Adult Health Nursing
Assignment;-Merle H,Mishel theory
By; - Mohammed
Abdela

BY;-Mohammed Abdela 01/04/2021 1

OUTLINE
 Introduction
 Accomplishments
 Uncertainty of illness theory overview
 Theory critique
 Why I choose Merle H. Mishel
 Purpose
 Concepts
 Definition of theory

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CONT…
 Relationships  Theory of Critique
 Structure of theory  Reference
 Assumption
 Theoretical source
 Major concepts &
definitions
 Theoretical assertion

BY;-Mohammed Abdela 01/04/2021 3

INTRODUCTION
 Mishel born in1939 in Boston,Massachusetts
 She graduated 1961 from Boston University in
Bachelors of Arts.
 In 1966 she got master of science in
psychiatric nursing

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CONT…
 Mishel completed her M.A. and Ph.D. in
social psychology at the Claremont Graduate
School in Claremont, California, in 1976 and
1980, respectively.
 She live from November 1939 up to April
2020 G.C

BY;-Mohammed Abdela 01/04/2021 5

ACCOMPLISHMENTS
 National institute in nursing research
 Nursing and related clinical sciences study
section
 Uncertainty in illness theory and scales

BY;-Mohammed Abdela 01/04/2021 6

CONTRIBUTIONS TO NURSING
AND HEALTH CARE
 National funding attained (ብሔራዊ የገንዘብ ድጋፍ ተገኝቷል)
 Theory applied in research studies around the
world(ቲዎሪ በዓለም ዙሪያ በሚገኙ የምርምር ጥናቶች ላይ
ተተግብሯል)
 New knowledge gained in nursing and other
specialties.(በነርሲንግ እና በሌሎች ልዩ መስኮች የተገኘ አዲስ
እውቀት)
 Changes in practice have occurred. (በተግባር ላይ ለውጦች
ተደርገዋል)
 Applying goal into nursing . (ግብ ወደ ነርሲንግ ማመልከት)
 positive patient outcome.(አዎንታዊ የታካሚ ውጤት)
 Accomplishment lead to professional recognition.
(ማከናወን ወደ ሙያዊ እውቅና ይመራል)
BY;-Mohammed Abdela 01/04/2021 7
THEORY LINK TO CLINICAL
PRACTICE (EXPLORED FURTHER)
 Knowledge attained from mishel’s theory.
(ከንድፈ ሀሳብ የተገኘ እውቀት)
 Theory affect on patient care.(ቲዮሪ በታካሚ
እንክብካቤ ላይ ተጽዕኖ ያሳድራል)
 Apply new knowledge into practice.( አዲስ
ዕውቀትን በተግባር ላይ ያውሉ)

BY;-Mohammed Abdela 01/04/2021 8

WHY I CHOOSE MERLE MISHEL
 Working in variety of health care setting.
(በተለያዩ የጤና እንክብካቤ ቅንጅቶች ውስጥ መሥራት)
 Uncertainty experienced in acute and
chronic illness.(አጣዳፊ እና ሥር የሰደደ ሕመም
ያጋጠመው እርግጠኛ አለመሆን)
 Intervention to aid in the patients coping.
(በሚቋቋሙ ሕመምተኞች ላይ ለመርዳት ጣልቃ ገብነት)
 Improving on excellent theory based care.
(በጥሩ የንድፈ ሀሳብ ላይ የተመሠረተ እንክብካቤን
ማሻሻል)

BY;-Mohammed Abdela 01/04/2021 9

UNCERTAINTY OF ILLNESS
THEORY OVERVIEW
 How the patient reacts to uncertainty?
(ሕመምተኛው እርግጠኛ ላለመሆን እንዴት ምላሽ ይሰጣል?)
 Nursing intervention to aid in uncertainty.
(እርግጠኛ ባልሆነ ሁኔታ ለመርዳት የነርሶች ጣልቃ ገብነት)
 Development of the theory(የንድፈ-ሀሳብ እድገት)
 Increase and decrease in uncertainty.(እርግጠኛ
አለመሆንን መጨመር እና መቀነስ)
 Uncertainty in illness scale.(በሕመም ሚዛን ላይ
እርግጠኛ አለመሆን)
 Theory 3 major structure providers.(ቲዎሪ 3 ዋና
መዋቅር አቅራቢዎች)

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CONT…
 Uncertainty is the central theoretical
concept, defined as the inability to
determine the meaning of illness-related
events inclusive of inability to assign
definite value and/or to accurately predict
outcomes (Mishel, 1988). (እርግጠኛ አለመሆን
የሕመምን ነክ ክስተቶች ትርጉም ለመወሰን አለመቻልን
የሚያመለክት ነው ፣ ይህም የተወሰነ እሴት ለመመደብ
እና / ወይም ውጤቶችን በትክክል ለመተንበይ አለመቻል
ነው)

BY;-Mohammed Abdela 01/04/2021 11

CONT…
 Another concept central to the uncertainty
theory is cognitive schema, which is defined
as the person’s subjective interpretation of
illness-related events .
ወደ እርግጠኛ አለመሆን ፅንሰ-ሀሳብ ሌላኛው ፅንሰ-ሀሳብ
የእውቀት (ኮግኒቲቭ) መርሃግብር ነው ፣ እሱም ግለሰቡ
ከህመም ጋር የተዛመዱ ክስተቶችን እንደየግላዊ
ትርጓሜው ይተረጎማል

BY;-Mohammed Abdela 01/04/2021 12

CONT…
 The UIT is organized around three major
themes related to the concepts: (UIT ከፅንሰ-
ሀሳቦቹ ጋር በተዛመዱ በሦስት ዋና ዋና ጭብጦች ዙሪያ
የተደራጀ ነው)
(a)antecedents of uncertainty,(ያለመተማመን
ቀደምትነት)
(b) appraisal of uncertainty(እርግጠኛ
አለመሆንን መገምገም)
(c) coping with uncertainty (እርግጠኛ
አለመሆንን መቋቋም )

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MAJOR CONCEPTS & DEFINITIONS

 UNCERTAINTY

Uncertainty is that the inability to work out the meaning of illness-

related events, occurring when the choice maker is unable to assign
definite value to things or events, or is unable to predict outcomes
accurately (Mishel, 1988).(እርግጠኛ አለመሆን ከህመም ጋር የተዛመዱ ክስተቶችን
ትርጉም በትክክል አለመረዳት ሲሆን ፣ ምርጫ ሰጪው ለነገሮች ወይም ለክስተቶች የተወሰነ
እሴትን መስጠት በማይችልበት ወይም ውጤቱን በትክክል መተንበይ በማይችልበት ጊዜ
የሚከሰት ነው)
 COGNITIVE SCHEMA
Cognitive schema may be a person’s subjective interpretation of illness,
treatment, and hospitalization (Mishel, 1988).(የእውቀት (ኮግኒቲቭ) መርሃግብር
የአንድ ሰው የሕመም ፣ የሕክምና እና የሆስፒታል መተርጎም ሊሆን ይችላል)
 STIMULI FRAME
Stimuli frame is that the form, composition, and structure of the stimuli
that an individual perceives, which are then structured into a cognitive
schema (Mishel, 1988). ( እስቲሚል ክፈፍ አንድ ግለሰብ የሚገነዘባቸው
የማነቃቂያዎች ቅርፅ ፣ ቅንብር እና አወቃቀር ሲሆን ከዚያ በኋላ ወደ የእውቀት (ኮግኒቲቭ)
መርሃግብር የተዋቀሩ ናቸው)

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CONT…
 Symptom Pattern
Symptom pattern is that the degree to which symptoms occur
with sufficient consistency to be perceived as having a pattern or
configuration (Mishel, 1988). የምልክት ንድፍ ምልክቶች ወይም አወቃቀር
እንዳላቸው ለመገንዘብ በበቂ ወጥነት ምልክቶች የሚከሰቱበት ደረጃ ነው
 Event Familiarity
Event familiarity is that the degree to which a situation is
habitual or repetitive, or contains recognized cues (Mishel,
1988). (የክስተት መተዋወቅ ማለት አንድ ሁኔታ ልማድ ወይም ተደጋጋሚ የሆነ
ወይም እውቅና ያላቸውን ምልክቶች የያዘ ነው)
 Event Congruence
Event congruence refers to the consistency between the
expected and therefore the experienced in illness-related
events (Mishel, 1988). የክስተት መገጣጠም የሚጠበቀው እና ስለሆነም
ከበሽታ ጋር በተዛመዱ ክስተቶች ልምድ ባላቸው መካከል ያለውን ወጥነት
ያመለክታል

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CONT…
 Structure providers
are the resources available to help the person within
the interpretation of the stimuli frame (Mishel,
1988). የመዋቅር አቅራቢዎች በተነቃቃቂው ፍሬም ውስጥ
ያለውን ሰው ለመርዳት የሚገኙ ሀብቶች ናቸው
 Credible Authority

Credible authority is that the degree of trust and

confidence an individual has in his or her healthcare
providers (Mishel, 1988). እምነት የሚጣልበት ባለስልጣን
አንድ ግለሰብ በእሱ የጤና እንክብካቤ አቅራቢዎች ላይ ያለው
የመተማመን እና የመተማመን መጠን ነው

BY;-Mohammed Abdela 01/04/2021 16

CONT…
 Social Supports
Social supports influence uncertainty by assisting the
individual to interpret the meaning of events (Mishel,
1988). ማህበራዊ ድጋፎች ግለሰቦችን የዝግጅቶችን ትርጉም እንዲተረጉም
በመርዳት እርግጠኛ አለመሆን ላይ ተጽዕኖ ያሳድራሉ
 Cognitive capacities
Cognitive capacities are the information-processing abilities
of an individual , reflecting both innate capabilities and
situational constraints (Mishel, 1988). የግንዛቤ አቅሞች የግለሰቡን
የመረጃ አቅም ማቀናበር ችሎታዎች እና ውስጣዊ ችሎታዎችን እና ሁኔታዊ
ገደቦችን የሚያንፀባርቁ ናቸው
 Inference
Inference refers to the evaluation of uncertainty using
related, recalled experiences (Mishel, 1988). ማጣቀሻ ተዛማጅ
የሆኑ ፣ የተረሱ ልምዶችን በመጠቀም ያለመተማመን ግምገማን ያመለክታል

BY;-Mohammed Abdela 01/04/2021 17

CONT…
 ILLUSION
Illusion refers to beliefs constructed out of uncertainty (Mishel,
1988). ቅዥት ያለ ጥርጥር የተገነቡ እምነቶችን ያመለክታል
 ADAPTATION
Adaptation reflects biopsychosocial behavior occurring within
persons’ individually defined range of usual behavior (Mishel,
1988). ማመቻቸት በሰዎች በተናጥል በተገለጸው የተለመዱ ባህሪዎች ውስጥ
የሚከሰተውን የባዮፕሲ-ማህበራዊ ባህሪን ያንፀባርቃል
 NEW VIEW OF LIFE
New view of life refers to the formulation of a replacement sense
of order, resulting from the mixing of continual uncertainty into
one’s self-structure, during which uncertainty is accepted as the
natural rhythm of life (Mishel, 1988). አዲስ የሕይወት እይታ
የሚያመለክተው የማያቋርጥ እርግጠኛነት ወደ አንድ ሰው የራስ-አወቃቀር ውስጥ
በመደባለቅ ምክንያት የሚመጣውን የመተኪያ ስሜት መተካት ነው ፣ በዚህ ወቅት
እርግጠኛ አለመሆን የሕይወት ተፈጥሮአዊ ምት ሆኖ ይቀበላል

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CONT…

 Probabilistic
thinking
refers to a belief during a conditional
world during which the expectation of
continual certainty and predictability is
abandoned (Mishel, 1988). ፕሮባብሊካዊ
አስተሳሰብ የማያቋርጥ እርግጠኛነት እና መተንበይ
ተስፋው በሚተውበት ሁኔታዊ ዓለም በሚኖርበት ጊዜ
አንድን እምነት ያመለክታል

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UNCERTAINTY IN ILLNESS SCALE
OF DIAGRAM

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CONT…
 The original scale has been used because the basis for the
subsequent three additional scales. ለቀጣይ ሶስት ተጨማሪ ሚዛን
መሠረት የሆነው የመጀመሪያው ሚዛን ጥቅም ላይ ውሏል
1. A community version (MUIS-C) for chronically ill individuals
who aren't hospitalized or receiving active medical aid.
ሆስፒታል ውስጥ ላልተገኙ ወይም ንቁ የሕክምና ዕርዳታ ለሌላቸው ሥር የሰደደ
ሕመም ላላቸው ግለሰቦች የማህበረሰብ ስሪት (MUIS-C)
2. A measure of parents’ perceptions of uncertainty (PPUS)
with regard to their child’s illness experience. የልጃቸውን
የሕመም ተሞክሮ በተመለከተ የወላጆችን እርግጠኛ አለመሆን (PPUS) ምልከታ

3. A measure of uncertainty in spouses or other relations when

another member of the family is acutely ill (PPUS-FM). ሌላ
የቤተሰብ አባል በከፍተኛ ሁኔታ በሚታመምበት ጊዜ በትዳር ጓደኞች ወይም
በሌሎች ግንኙነቶች ላይ እርግጠኛ አለመሆን ልኬት (PPUS-FM)

BY;-Mohammed Abdela 01/04/2021 21

THEORETICAL SOURCES
 When Mishel began her research into
uncertainty, the concept had not been
applied within the health and illness context
ሚሸል ጥናቷን ወደ እርግጠኛ አለመሆን በጀመረች ጊዜ
ፅንሰ-ሀሳቡ በጤና እና በህመም ሁኔታ ውስጥ
አልተተገበረም.

BY;-Mohammed Abdela 01/04/2021 22

CONT…
 Heroriginal Uncertainty in Illness Theory
(Mishel, 1988) drew from existing information-
processing models (Warburton, 1979) and
personality research (Budner, 1962) from
psychology that characterized uncertainty as
a state of mind resulting from insufficient cues
with which to make a cognitive schema
or representation of a situation or event.
የመጀመሪያዋ በሕመም ንድፈ-ሀሳብ (ሚሸል ፣ 1988) ውስጥ
ካሉ ነባር የመረጃ አሰራጭ ሞዴሎች (ዋርበርተን ፣ 1979) እና
ከሰውነት ምርምር (ቡድነር ፣ 1962) የተወሰደ ነው ፡፡ የግንዛቤ
እቅድ ወይም የአንድ ሁኔታ ወይም ክስተት ውክልና

BY;-Mohammed Abdela 01/04/2021 23

THEORETICAL ASSERTIONS

Mishel asserted the following (1988, 1990):

 Uncertainty occurs when an individual cannot adequately
structure or categorize an illness-related event due
to the shortage of sufficient cues. እርግጠኛ አለመሆን አንድ
ግለሰብ በበቂ ፍንጮች እጥረት ምክንያት ከበሽታ ጋር የተዛመደ ክስተት
በበቂ ሁኔታ ማዋቀር ወይም መመደብ በማይችልበት ጊዜ ይከሰታል
 Uncertainty can take the shape of ambiguity, complexity,
lack of or inconsistent information, or unpredictability.
እርግጠኛ አለመሆን የአሻሚነት ፣ የተወሳሰበ ፣ እጥረት ወይም
የማይጣጣም መረጃ ወይም ያልተጠበቀ ቅርፅን ሊወስድ ይችላል።
 As symptom pattern, event familiarity, and event
congruence (stimuli frame) increase, uncertainty
decreases. እንደ የምልክት ንድፍ ፣ የክስተት መታወቅ እና የዝግጅት
ትስስር (ማነቃቂያ ፍሬም) እየጨመሩ ፣ እርግጠኛ አለመሆን ይቀንሳል ፡፡

BY;-Mohammed Abdela 01/04/2021 24

CONT…
 Structure providers (credible authority, social support, and
education) decrease uncertainty directly by promoting
interpretation of events, and indirectly by strengthening the
stimuli frame. የመዋቅር አቅራቢዎች (ተአማኒነት ያለው ባለስልጣን ፣
ማህበራዊ ድጋፍ እና ትምህርት) የዝግጅቶችን ትርጓሜ በማስተዋወቅ እና
በተዘዋዋሪ ቀስቃሽ ማዕቀፉን በማጠናከር እርግጠኛ አለመሆንን በቀጥታ
ይቀንሳሉ ፡፡
 Uncertainty appraised as danger prompts coping efforts
directed at reducing the uncertainty and managing
the arousal generated by it. እርግጠኛ ባልሆነ ሁኔታ በአደገኛ ሁኔታ
መሞከሩ እርግጠኛ አለመሆንን ለመቀነስ እና በእሱ የተፈጠረውን ተነሳሽነት
ለመቆጣጠር የተደረጉ ጥረቶችን ለመቋቋም ይረዳል ፡፡
 Uncertainty appraised as opportunity prompts coping efforts
directed at maintaining the uncertainty. እንደ እድል ሆኖ መረጋገጡ
እርግጠኛ አለመሆንን ለመጠበቅ የሚረዱ ጥረቶችን ለመቋቋም ይገፋፋል

BY;-Mohammed Abdela 01/04/2021 25

CONT…
 The influence of uncertainty on psychological outcomes is
mediated by the effectiveness of coping efforts to scale
back uncertainty appraised as danger or to take care
of uncertainty appraised as opportunity. በስነልቦና ውጤቶች ላይ
ያለመተማመን ተጽዕኖ በአደገኛ ሁኔታ የተጠረጠረውን እርግጠኛ አለመሆን ወደኋላ
ለመመለስ ወይም እንደ እድል የተጠረጠረውን እርግጠኛነት ለመንከባከብ በሚደረገው
ጥረት ውጤታማነት መካከለኛ ነው ፡፡
 When uncertainty appraised as danger can't be reduced
effectively, coping strategies are often employed to manage the
emotional response. እንደ አደገኛ ሁኔታ በተገመተ እርግጠኛነት ውጤታማ
በሆነ መንገድ ሊቀነስ በማይችልበት ጊዜ ፣ ስሜታዊ ​ ምላሹን ለማስተዳደር
የመቋቋም ስልቶች ብዙውን ጊዜ ጥቅም ላይ ይውላሉ ፡፡
 The longer uncertainty continues within the illness context, the
more unstable the individual’s previously accepted mode of
functioning becomes. ረዘም ያለ እርግጠኛ አለመሆን በሕመሙ ሁኔታ ውስጥ
ይቀጥላል ፣ ግለሰቡ ከዚህ በፊት ተቀባይነት ያገኘበት የአሠራር ሁኔታ ይበልጥ
የተረጋጋ ይሆናል።
BY;-Mohammed Abdela 01/04/2021 26
CONT…
 Under conditions of putting up with uncertainty, individuals
may develop a replacement , probabilistic perspective on life,
which accepts uncertainty as a natural a part of life. እርግጠኛ
አለመሆንን በሚሸከሙበት ሁኔታ ውስጥ ውስጤን መተማመንን እደግሳለሁ
የሂወቴ አስተላላፊ አመለካከት እንደ ተፈጥሮአዊ አካል በሕይወታችን ውስጥ
የመተካት ዕድልን ሊያሳዩ ይችላሉ
 The process of integrating continual uncertainty into a
replacement view of life are often blocked or prolonged by
structure providers who don't support probabilistic thinking.
የማያቋርጥ አለመተማመንን ወደ ሕይወት ምትክ እይታ የማዋሃድ ሂደት
ብዙውን ጊዜ ፕሮባቢሊቲ አስተሳሰብን በማይደግፉ የመዋቅር አቅራቢዎች
ይታገዳል ወይም ይረዝማል
 Prolonged exposure to uncertainty appraised as danger
can cause intrusive thoughts, avoidance, and severe emotional
distress. ለረዥም ጊዜ ለአደጋ ተጋላጭ ለሆነ እርግጠኛነት መጋለጥ ጣልቃ-ገብ
ሀሳቦችን ፣ መራቅን እና ከባድ የስሜት ቀውስ ያስከትላል
BY;-Mohammed Abdela 01/04/2021 27
THEORY CRITIQUE
የንድፈ ሀሳብ ትችት
 Theory description (የንድፈ ሀሳብ መግለጫ)
 Purpose
 Definitions
 Structures
 Concepts
 Relationships
 Assumptions(ግምቶች)

BY;-Mohammed Abdela 01/04/2021 28

PURPOSE
 Middle range theory
 Coping, processing and antecedents
 Appropriate interventions
 Research focus

BY;-Mohammed Abdela 01/04/2021 29

 CONCEPTS
 Addressing the amount of uncertainty
 MUIS Design to measure uncertainty
 Scales support theory highly testable
 Adult uncertainty in illness scale
 Parents perception of uncertainty in illness

BY;-Mohammed Abdela 01/04/2021 30

DEFINITION OF THEORY
 Patients cognitive reaction
 Nursing support and interventions
 The original uncertainty in illness theory
(UIT) was developed by Mishel to address
uncertainty during the diagnostic and
treatment phases of an illness or an illness
with a determined downward trajectory
(Mishel, 1988).

BY;-Mohammed Abdela 01/04/2021 31

CONT…
 Subsequently a reconceptualized uncertainty
in illness theory (RUIT) was developed by
Mishel to address the experience of living
with continuous uncertainty in either a
chronic illness requiring ongoing
management or an illness with a possibility
of recurrence (Mishel, 1990).

BY;-Mohammed Abdela 01/04/2021 32

CONT…
 Sincedevelopment of the original theory, the
concept of uncertainty has been used in
many disciplines including nursing, medicine,
and health communication with slightly
differing definitions, extensions, and
applications.

BY;-Mohammed Abdela 01/04/2021 33

CONT…
 Companion instruments to measure
uncertainty in illness have
been translated into many languages and
used extensively (Mishel 1983a,
1997c).

BY;-Mohammed Abdela 01/04/2021 34

RELATIONSHIPS
 Uncertainty in illness and patients
adaptation
 Health care provider awareness of
uncertainty
 Appropriate interventions
 Guidance of patient and their family

BY;-Mohammed Abdela 01/04/2021 35

CONT..
 How patient adapt to uncertainty
 ambiguity
 complexity
 inconsistency
 unpredictability
 social support
 education
 credible authorities

BY;-Mohammed Abdela 01/04/2021 36

STRUCTURE OF THEORY
 Stress,appraisal,coping and adaptation frame
work.
 Factors influencing coping
 education
 support system
 credible authority
Uncertainty negative and positive
Uncertainty stressor in illness

BY;-Mohammed Abdela 01/04/2021 37

ASSUMPTION(ግምቶች)
 Understanding the definition of uncertainty
 How uncertainty is experienced
 adaptation affected by multiple factors
 Patients need time to focus on self

BY;-Mohammed Abdela 01/04/2021 38

THEORY OF CRITIQUE
 Critical reflection of the theory
 clarity(ግልጽነት)
 simplicity (ቀላልነት)
 generalizability (አጠቃላይነት)
 accessibility (ተደራሽነት)
 importance (አስፈላጊነት)

BY;-Mohammed Abdela 01/04/2021 39

CLARITY
 Easily understood and interpreted
 Utilize in 30 countries around the world
 Theory translated in 15 different languages

BY;-Mohammed Abdela 01/04/2021 40

SIMPLICITY
 Concise (ማጠቃለያ)
 Definition clear and simple
 Use uncertainty in illness scale
 Decrease the level of difficulty

BY;-Mohammed Abdela 01/04/2021 41

GENERALITY

 Wide range use of uncertainty theory

 Applied in acute and chronic illness
 cancer, cardiac disease and trauma injury
 Applied to research around the world and
united state

BY;-Mohammed Abdela 01/04/2021 42

ACCESSIBILITY
 What areas of illness causing uncertainty
 Increasing coping mechanism
 Guides health care professionals
 improve interaction and care of patients
 educating the patient on their illness
 why or how the illness began
 how illness progresses
 how the patient can recover

BY;-Mohammed Abdela 01/04/2021 43

IMPORTANCE
 Guides health care providers
 how uncertainty affects the care and out
come of the patients health.
 Changes in practice
 Alleviating the patient uncertainty( የታካሚውን
እርግጠኛ አለመሆን ማቅለል)
 Determining better outcomes .(የተሻሉ
ውጤቶችን መወሰን)
 Using uncertainty in theory scales

BY;-Mohammed Abdela 01/04/2021 44

SUMMARY
 provides a comprehensive framework to view the
experience of acute and chronic illness and to
organize nursing interventions. የድንገተኛ እና ሥር
የሰደደ በሽታ ልምድን ለመመልከት እና የነርሶች ጣልቃ-ገብነትን
ለማደራጀት አጠቃላይ ማዕቀፍ ይሰጣል

 to explain the stresses associated with

the diagnosis and treatment of major illnesses or
chronic conditions. ዋና ዋና በሽታዎችን ወይም ሥር የሰደደ
ሁኔታዎችን ከመመርመር እና ሕክምና ጋር የተያያዙትን
ጭንቀቶች ለማብራራት

BY;-Mohammed Abdela 01/04/2021 45

CONT…
 to addresses the unique context of continual uncertainty
and thereby expands the original theory to encompass the
ongoing uncertain trajectory of many life-threatening and
chronic illnesses. የማያቋርጥ እርግጠኛ አለመሆንን ልዩ ሁኔታ
ለመቅረፍ እና በዚህም የመጀመሪያውን ለሕይወት አስጊ እና ሥር የሰደደ
በሽታዎችን የማያቋርጥ እርግጠኛ ያልሆነ አቅጣጫን ለማካተት
የመጀመሪያውን ፅንሰ-ሀሳብ ያሰፋዋል ፡፡

 to explain the importance of professional caregivers in

providing information and supporting individuals in
understanding and managing uncertainty. ሙያዊ
ተንከባካቢዎች መረጃን በማቅረብ እና እርግጠኛ አለመሆንን በመረዳት እና
በማስተዳደር ግለሰቦችን በመደገፍ ረገድ አስፈላጊ መሆኑን ለማስረዳት ፡፡

BY;-Mohammed Abdela 01/04/2021 46

CONT….
 Goalto alleviate uncertainty
 Widely used Theory

BY;-Mohammed Abdela 01/04/2021 47

REFERENCE

 Arias-Rojas, M., et al. (2019). "Uncertainty in illness

in family caregivers of palliative care patients and
associated factors." Rev Lat Am Enfermagem 27:
e3200.
 Giammanco, M. D., et al. (2015). "Adaptation of the
Mishel Uncertainty of Illness Scale (MUIS) for chronic
patients in Italy." J Eval Clin Pract 21(4): 649-655.
 Lin, L., et al. (2010). "Evaluation of a conceptual
model based on Mishel's theories of uncertainty in
illness in a sample of Taiwanese parents of children
with cancer: a cross-sectional questionnaire survey."
Int J Nurs Stud 47(12): 1510-1524.

BY;-Mohammed Abdela 01/04/2021 48

CONT…
 Mishel, M. H., et al. (1991). "Uncertainty in illness theory: a
replication of the mediating effects of mastery and coping."
Nurs Res 40(4): 236-240.
 Rising, K. L., et al. (2020). "Development of the Uncertainty
Communication Checklist: A Patient-Centered Approach to
Patient Discharge From the Emergency Department." Acad Med
95(7): 1026-1034.
 Simpkin, A. L. and K. A. Armstrong (2019). "Communicating
Uncertainty: a Narrative Review and Framework for Future
Research." J Gen Intern Med 34(11): 2586-2591.
 Zhang, D., et al. (2018). "Illness uncertainty, anxiety and
depression in Chinese patients with glaucoma or cataract." Sci
Rep 8(1): 11671.
 Zhang, Y. (2017). "Uncertainty in Illness: Theory Review,
Application, and Extension." Oncol Nurs Forum 44(6): 645-649.

BY;-Mohammed Abdela 01/04/2021 49

Thank you very much every body for
your Attention !!!

IF YOU QUESTI SUGGES COMME WELCO

HAVE ON TION NT ME
and

BY;-Mohammed Abdela 01/04/2021 50