This study examined the applicability of Mishel's model of uncertainty in illness (1990) to the adaptation process of women diagnosed with fibromyalgia. The power of uncertainty and social support to predict an uncertainty appraisal and its corresponding coping strategy utilized in this population were examined.Structural equation modeling was employed to clarify the relationships among uncertainty, social support, the appraisal of uncertainty as either danger or opportunity, and coping as either emotion-focused or problem-focused. One hundred sixty-five participants completed the Mishel Uncertainty in Illness Scale (MUIS-A), the Appraisal of Uncertainty Scale (AUS), the Jalowiec Coping Scale (JCS), and the Social Provision Scale (SPS). After an analysis of several measures of goodness-of-fit, the original model was modified based on theory, the modification indices, and a review of the maximum likelihood estimates (mle) for structural paths. These modifications resulted in a competing model. Finally, a Chi-square test was performed comparing the goodness-of-fit indices of the competing models.Results indicated that Mishel's model is a useful model within which to conceptualize the issues faced by women diagnosed with fibromyalgia. Mishel's model performed adequately; however, the overall goodness-of-fit was significantly improved by modifications which placed greater emphasis on social support. Social support and uncertainty exerted approximately equal effect on a danger appraisal and in the revised model only social support predicted an opportunity appraisal. Results also suggested that uncertainty had a direct effect on emotion-focused coping regardless of the appraisal of the uncertainty as danger or opportunity. The current study did not unequivocally support Mishel's assertion that uncertainty may be evaluated as an opportunity. Although uncertainty demonstrated a significant inverse relationship with an opportunity appraisal in the original model, in the revised model, which considered the direct effects of social support on the appraisal process, uncertainty failed to have a significant effect. Given the depth of evidence and applicability of Mishel's original model, additional research is necessary to determine whether these results are specific to the experience of fibromyalgia or perhaps social support is an under-appreciated factor in Mishel's model. Implications for treatment and directions for future research are explored. / Department of Counseling Psychology and Guidance Services
| Identifer | oai:union.ndltd.org:BSU/oai:cardinalscholar.bsu.edu:handle/175184 |
| Date | January 2006 |
| Creators | Bowers, Rhonda J. |
| Contributors | Gordon, Phyllis A. |
| Source Sets | Ball State University |
| Detected Language | English |
| Format | vii, 85 leaves : ill. ; 28 cm. |
| Source | Virtual Press |
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