THE CERTAINTY OF UNCERTAINTY
The paper initially defines and describes Mishel’s Uncertainty Theory, a few associated types of uncertainty and phases associated with processing uncertainty. The author goes on to detail the different components, types, and stages of uncertainty. Following the definition and types of uncertainty, the paper details aspects of attributing a positive or negative value to uncertainty and how a patient’s well being is tied to resolving perceived uncertainty. The author then bridges the aspects of uncertainty as they relate to illness and applications in patient care in nursing.
Definition and type of uncertainty
Initially, the author lays out the definition of the Uncertainty Theory, and details two different types of uncertainty and their phases of development. McCormick (2002) uses Mishel’s direct definition of the Uncertainty Theory and states the theory is, “a cognitive state created when the person cannot adequately structure or categorize an event because of the lack of sufficient cues. Uncertainty occurs in a situation in which the decision maker is unable to assign definitive value to object or events and/or events and/or is unable to predict outcomes accurately.” (p.127).
Health care practitioners rooted in science have a keen appreciation for the unknown and the process of discovery. Simply put, a comfort with things that are certain and uncertain. Medical scientists continually work within uncertainty, accept it as a natural state, for research to exist, and move to find knowledge, certainty, and prediction through clinical research (Seely, 2013,p.65,67). The two main types of uncertainty that have been identified as common aspects in medicine and the treatment of illness are: clinical un...
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...ional Certainty and Uncertainty on Coping Strategies." Social Behavior and Personality 38.1 (2010): 53-60. ProQuest Biology Journals. Web. 5 Feb. 2014. .
McCormick, Kim M. "A Concept Analysis of Uncertainty in Illness." Journal of Nursing Scholarship 34 (2002): 127-31. ProQuest. 4 Feb. 2014 .
Neville, Kathleen L. "Uncertainty of Illness: An Integrative Review." Orthopedic Nursing 22 (2003): 206-14. ProQuest. 4 Feb. 2014 .
Seely, Andrew J.E. "Embracing the Certainty of Uncertainty: Implications for Health Care and Research." Perspectives in Biology and Medicine 56.1 (2013): 65-77. ProQuest. Web. 4 Feb. 2014. .
The three of the medical values emotional detachment, mastering uncertainty and clinical experience are all connected to the article “What’s The Trouble” by Jerome Groopman. Emotional detachment can relate to the part of the article where Jerome was very upset at himself when he misdiagnosed Brad. “I was furious with myself. Because I liked Brad, I hadn’t wanted to add to his discomfort and had cut the examination short. Perhaps I hoped unconsciously that the cause of his fever was trivial and that I would not find evidence of an infection on his body” (Groopman). This shows how he had a connection with Brad because he liked him and when Brad came In with symptoms, Jerome had mis-diagnosed him because he did not emotionally detach himself. There wasn’t proof that it was definitely the reason but it would make sense when you look at the situation. The article also mentioned how Brads parents wanted to see Jerome, at first he did not want to see them because he was upset but that is when he pulled together and became strong and talked to them. The article is connected to mastering uncertainty because in the article it talks about the many mistakes they have made and how you have to learn how to deal with it. “When people are confronted with uncertainty-the situation of every doctor attempting to diagnose a patient-they are susceptible to unconscious emotions and personal biases, and are more likely to make cognitive errors” (Groopman). This description from the article connects emotions with mistakes. This connects the values of emotional detachment and mastering uncertainty. Mastering uncertainty is very important because you have to notice that you will make mistakes. The article talks about Croskerry and how he was surprised with the amount of errors that have been made. “Doctors typically begin to diagnose patients the moment they meet them” (Groopman). This shows that doctors often jump to conclusions and may not think about the issue. This can easily
With the high degree of variations in health care, patients can be under or over treated or even treated with the wrong treatment for their illness. These unwarranted care techniques can be categorized into three different situations. The first category of unwarranted care is the use of evidence or lack thereof, based on other medical care. The way to explain this category is that a care plan for a patient is proven effective without any proof as to why. The example given by Kongstvedt (2007) is the use of beta blockers post heart attack. Beta blockers prove to be effective in nearly one h...
Being knowledgeable and factual is key to providing an accurate and credible description to the patient. These points emphasize the importance of knowing and continuing to grow in the human science portion of
Uncertainty avoidance is the next cultural value to be considered. Joe’s owe culture, Sub-Saharan Africa, tends to be somewhere between low and high uncertainty avoidance. Low uncertainty avoidance being more comfortable with the uncertainty of outcomes and high uncertainty avoidance seeking to know the results from the onset of a course of action. Joe, personally, leans toward high uncertainty
The relationship between certainty and doubt has been a heavily debated topic throughout history and especially in the mid-1800s. For most people, having some doubt on one’s opinions is much more beneficial than having absolute certainty because doubt allows one to review his potential choice and leaves room for him to make improvements on his choice. Someone who lives with absolute certainty cannot weigh the pros and cons because he has the confidence that what he believes is the right decision for everyone; however, there are situations in one’s life where absolute certainty is necessary, such as in team sports. With the exception of competitions, however, it is more important for one to have doubt in his or her life because doubt allows
Some health care worker have perceptual barriers on research. They have a perception that research and clinical cannot mix as the parameters that were set in an RCT would not be translatable to the actual hospital or clinic setting. There is also a perception that, where would a patient with multiple past medical history, fit into such research findings (10).
Uncertainty in organizations is a key element to be dealt with in the areas of technology, rules and rituals (Hofstede, 1980). The notion of uncertainty is frequently connected to the perception of environment as the ‘environment is taken to include everything not under direct control of the organization as a source of uncertainty for which the organization tries to compensate’ (Hofstede, 1980: 155). The organization deals with uncertainty in the way in which uncertainties are observed inside the business. According to Torrington, uncertainty avoidance is the degree to which the future is always unknown (1994). Some cultures socialize their participants to accept this idea and take risks. Whereas members of other cultures have been socialized to be made worried or threatened by this and therefore, search for reparation through the ‘security of law, religion or technology’. (Torrington, 1994:
Uncertainty, according to the theory put into place by Merle Mishel, is the inablility to determine the meaning of illness-related events because of a lack of sufficient cues that allow patients to assign value to objects or events and accurately predict outcomes (Elphee, 2008). This author believes it is important for nurses to completely understand the patient as a whole and what they are experiencing when faced with a new and frightening diagnosis. It is necessary to supply patients with sufficient information regarding their diagnosis, if they desire. This author believes the Theory of Uncertainty may help the nurse understand more fully what challenges and uncertainty the patient is presented with when undergoing a new diagnosis.
The theory of uncertainty of illness by Mishel can be used in practice to provide direction for nurse to support patients in understanding and coping with uncertainty in illness (Masters, 2015). If all nurses understand the theory of uncertainty in illness, they can better assist their patients to have the best outcome. Nurses should be educated on this theory to be able to use it in practice. The theory has been used to educate clinicians of all areas on the understanding of patients as a whole and their situations during times of uncertainty (Mishel, 2014).
Certainty: The Certainty is defined as the state of being without doubt of one’s belief which can shape people thoughts, decisions, attitudes, and behaviors.
The possibility for our individuality to be understood and accepted in a social environment’s culture is low depending on how we manage the effects of uncertainty reduction theory and relational uncertainty. Uncertain reduction theory is described as “a lack of confidence about how an interpersonal interaction will proceed because of the challenge to describe, to explain, and to predict behaviour by gaining
Mishel’s (1988) Uncertainty in Illness theory is a mid-range nursing theory that examines how uncertainty can affect patients. In addition, Mishel’s theory identifies causes of uncertainty that negatively or positively affect the patient. If an individual is spiraling down a known path of illness, they may perceive uncertainty as a benefit. However, illness uncertainty causes breakdowns, fear of the illness, emotional distress, loss of control, and inappropriate coping methods (Mishel 1988). These conditions if left untreated will lead to patients that are unable to form cognitive structures for illness related events, develop improper psychological adjustments, poor decision-making, and traumatic stress responses (Mishel 1988). Along with her theory, Mishel (1988) developed a scale to rate uncertainty to measure the degree of an individual’s uncertainty during acute injuries, illness, and recurrence of chronic sickness. There is a desire to know what is happening to one’s body, and not understanding the illness will lead to patients being less comfortable. It is the obligation of the nursing profession to help patients understand what their illness means to them, expect outcomes, and managing the stress of uncertainty. Mishel’s theory (1981) is an important aspect of the nurse’s ability to overcome obstacles in place by uncertainty to benefit the well-being of patients.
Dr. Merle Mishel is an American, nursing theorist who is accredited with the creation of the uncertainty in illness theory and measurement scale. She holds both a master 's degree in psychiatric nursing and a PhD in social psychology. She has accrued many distinguished awards and honors for her works showcasing her expertise in dealing with psychosocial responses to cancer and chronic illness and also the best interventions to manage the hardship and stress that can accompany uncertainty when it comes to illness. Dr. Mishel, currently she holds a position at University of North Carolina at Chapel Hill School of Nursing as a Kenan Professor of Nursing, where she continues her teachings, research and advocating of cancer patients and those with
It displays how a society deals with any ambiguous or unknown situations and based on that situation develop beliefs. U.S. scores 46% on the uncertainty avoidance dimension since it is regulated by laws and norms that reduce ambiguity among the society people. Whereas India is a flexible country, where fewer rules are followed, change is accepted easily, and risk taking is more common (Hofstede, 2001). Thus, India has a medium to low 40% preference for avoiding uncertainty. It is evident that such different outlooks on avoiding uncertainty certainly impact work relationships between U.S. and
“Nothing can be known with certainty'; Is this statement true? Are you certain? In this essay I plan to show that nothing can be known with certainty, I will examine the truth and certainty of life and of humans, and prove that nothing can be known for certain.