Objectives: Theoretical models have helped conceptualise how individuals appraise and make sense of chronic illness and its psychological impact. Little attention has been given to the impact of uncertainty on this process. The objective was to investigate the relationship between levels of uncertainty, illness representations, coping, psychological and physical functioning in two chronic illnesses. The Self-Regulatory Model (SRM, Leventhal, Meyer & Nerenz, 1980) was used as a theoretical framework. Design: A cross-sectional design was used. It was hypothesised that a clear medical diagnosis would reduce levels of uncertainty and increase illness representations regarding control of symptoms. It was also hypothesised that high levels of uncertainty would independently predict increased psychological distress. Method: Patients suffering from chronic spinal pain and rheumatoid arthritis were recruited from local clinical departments. The levels of uncertainty, illness representations, coping strategies, mood and physical functioning of 85 participants were assessed using standardised questionnaires. Results: Chronic pain patients were found to have greater levels of uncertainty and psychological distress than rheumatoid arthritis patients. Rheumatoid arthritis patients had stronger beliefs about control of their condition. Uncertainty was not found to be a significant independent predictor of anxiety or depression. However, there appeared to be a degree of overlap between the variables of uncertainty and control beliefs. Conclusions: The findings highlight a complex relationship between the aspects of the SRM and uncertainty, with many components impacting on each other. Although levels of uncertainty were not found to be predictive of psychological distress, it is an area that warrants further investigation in order to understand how patients manage uncertainty. Within a clinical setting, issues of uncertainty should be addressed at all levels of care, maximising the patient's control beliefs, reducing the impact of uncertainty on their cognitive, emotional and physical functioning.
| Identifer | oai:union.ndltd.org:bl.uk/oai:ethos.bl.uk:368283 |
| Date | January 2001 |
| Creators | Homewood, Helen |
| Publisher | University of East Anglia |
| Source Sets | Ethos UK |
| Detected Language | English |
| Type | Electronic Thesis or Dissertation |
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