University of North Carolina at Chapel Hill.
University of North Carolina.
Oncol Nurs Forum. 2020 Nov 1;47(6):721-731. doi: 10.1188/20.ONF.721-731.
Guided by Mishel's uncertainty in illness theory, patterns of change in uncertainty were explored over time for patients with prostate cancer and their partners. In addition, the relationships between uncertainty and its antecedents were examined, and the role effects (patient versus partner) on these relationships were assessed.
SAMPLE & SETTING: This study is a secondary analysis of the longitudinal data collected from a randomized clinical trial.
METHODS & VARIABLES: The current authors fitted multiple-level models that included time-invariant baseline variables (sociodemographics and cancer factors) and time-varying variables (uncertainty, symptoms, and social support) measured at baseline and at 4, 8, and 12 months thereafter.
No statistically significant patterns of change in uncertainty over time were detected. Partners reported greater uncertainty than patients. Higher uncertainty was associated with more general and prostate cancer-specific symptoms, recurrent and advanced prostate cancer, higher prostate-specific antigen level, and lower social support. More urinary symptoms were associated with greater uncertainty in patients than in partners.
Uncertainty management can be tailored for and target symptom management and social support.
以米歇尔疾病不确定理论为指导,探讨前列腺癌患者及其伴侣的不确定性随时间的变化模式。此外,还检验了不确定性与其前因之间的关系,并评估了这些关系中的角色效应(患者与伴侣)。
本研究是对随机临床试验中收集的纵向数据进行的二次分析。
本研究作者拟合了多水平模型,其中包括基线时的时间不变量(社会人口统计学和癌症因素)和随后在基线和 4、8 和 12 个月测量的时变变量(不确定性、症状和社会支持)。
未检测到不确定性随时间的显著变化模式。伴侣报告的不确定性大于患者。较高的不确定性与更一般和前列腺癌特异性症状、复发性和晚期前列腺癌、较高的前列腺特异性抗原水平以及较低的社会支持相关。与伴侣相比,患者的尿症状与更大的不确定性相关。
不确定性管理可以针对症状管理和社会支持进行定制。