Illness uncertainty-a state of struggling to make sense of illness-related events-contributes to distress among parents of children with cancer. While some illness uncertainty is inescapable, uncertainty may be minimized through interventions targeting modifiable antecedents. Within the context of childhood cancer, parent and child characteristics associated with high illness uncertainty have not been identified. We sought to describe illness uncertainty among parents of children with cancer and explore potential associations with parent/child characteristics to identify populations that might benefit most from interventions to mitigate illness uncertainty.

We conducted an exploratory cross-sectional analysis of parent-reported survey data. We recruited parents of children with cancer cared for at a single academic pediatric cancer program in the northeastern United States who participated in two prospective studies (n = 89 parents) between September 2016 and June 2018. Illness uncertainty was measured by the 31-item Parent Perception of Uncertainty Scale (PPUS).

PPUS score distribution was slightly right-skewed. Median PPUS score was 74, with an interquartile range of 67-83. Twenty-four percent of parents strongly endorsed uncertainty regarding future planning, what their child can and cannot do, and their child's illness trajectory. Twenty percent strongly endorsed uncertainty from unanswered questions. Only 3% of parents reported their child's treatment regimen was too complex to understand. No significant associations were found between PPUS and parent/child characteristics.

Future studies should examine additional parent and child characteristics to identify whether specific subgroups of parents may benefit most from interventions to reduce and manage illness uncertainty.

Despite the proven benefits of early palliative care, patient communication regarding these services remains elusive. Therefore, this paper aims to (a) provide a focused literature review on nurse palliative care communication addressing chronic uncertainty in life-limiting illness (LLI), (b) define the Reconceptualization of Uncertainty in illness Theory and Problematic Integration Theory within a nursing Unitary Caring Science philosophical worldview and, (c) synthesize these theories and literature review into a unique theoretical framework for early palliative care communication in acute care nursing.

Turner's theory synthesis methodology was combined with a PRISMA-style literature review. The literature search was conducted in July 2023 and updated in May 2024 using EBSCOhost, Pubmed, and PsychINFO databases. A second literature search was undertaken to identify applicable uncertainty theories in chronic or LLIs.

This theory synthesis highlights the interconnectedness of all facets of uncertainty for those living with severe LLI (personal factors, types of uncertainty, and the nursing communicatory process) and conceptualizes uncertainty communication as a series of events happening simultaneously, not simply a cause-and-effect process.

The framework resulting from this synthesis encourages nurses' holistic understanding of the complex nature of uncertainty in LLI, highlights the integral communicatory role nurses have in their patients' health and wellness, and promotes further nursing-specific communication research. Future research on enabling nurse-initiated early palliative care communication and narrative communication techniques will support patients' values and dignity throughout more than a single hospital stay but their entire disease trajectory.

Parents of newly diagnosed cancer children often experience significant concerns about the implications of the diagnosis. They find themselves in challenging decision-making situations, navigating through uncertain conditions following the disclosure. Uncertainty is a prevailing issue in healthcare, yet its interpretation and application within the context of health and nursing practice exhibit multiple meanings and variations.

This study aimed to clarify the concept of parental uncertainty arising from having children with cancer.

The concept analysis followed the steps outlined by Walker and Avant. A thorough literature search was conducted using the Embase, CINAHL, and MEDLINE databases to identify articles published between 1980 and 2022.

The literature search yielded 147 articles from various disciplines, including health, nursing, medicine, psycho-oncology, and management. After analysis, 20 articles were selected for inclusion. This study identified four key attributes of parental uncertainty associated with having a child with cancer: (1) emotional disturbance, (2) unpredictability, (3) insufficient information, and (4) problems with decision-making. The antecedents of parental uncertainty encompassed the complexity of the disease, the diagnostic and treatment processes, the hospital environment, communication, and support from credible authorities. The consequences of parental uncertainty included the pursuit of new information, parental adaptability to their role, and parental distress.

Understanding the four attributes of parental uncertainty, along with their antecedents and consequences, can facilitate the future development and operational translation of the concept of uncertainty in nursing practice. This concept is valuable in the evidence-based provision of nursing care to parents of children with cancer, enabling comprehensive recognition and assessment of parental uncertainty and the implementation of appropriate interventions that are sensitive to parental experiences. Ultimately, this approach promotes the adaptation of both the child and the parent.

This study aimed to clarify if sense of coherence (SOC) could be used as an element of primary-focused health services in schools.

The United Arab Emirates (UAE) is striving to develop a high-quality, primary-focused health care system. School health care services are well established in the UAE but have not yet been fully used to play a key role in this development.

This is a cross-sectional survey study to explore adolescents' SOC and their behavioural, psychosocial and clinical outcomes.

A total of 408 adolescents participated in this study. Compared with others, adolescents with higher SOC had better adherence to treatment, fewer visits to the school nurse, better self-efficacy, fewer hyperactivity problems, fewer emotional problems, more prosocial behaviours and fewer conduct problems.

Implementing interventions that improve SOC may support improved well-being among adolescents. The findings also support the use of SOC and salutogenesis as a framework to reinforce primary health care services for this population.

Health service managers can utilize SOC as a framework to focus service on illness prevention and health promotion, they should collaborate with education authorities to include more health-related topics as part of school curricula to promote students' SOC and, finally, they should assess and build awareness of SOC and associated tools among school nurses and primary health care providers.

Stroke has a great influence on the patient's mental health, and reasonable psychological adjustment and disease perception can promote the recovery of mental health.

To explore the relationships among resilience, coping style, and uncertainty in illness of stroke patients.

A retrospective study was used to investigate 154 stroke patients who were diagnosed and treated at eight medical institutes in Henan province, China from October to December 2019. We used the Mishel Uncertainty in Illness Scale, the Connor-Davidson Resilience Scale, and the Medical Coping Modes Questionnaire to test the uncertainty in illness, resilience, and coping style, respectively.

Resilience had a significant moderating role in the correlation between coping style and unpredictability and information deficiency for uncertainty in illness (P < 0.05). Further, the tenacity and strength dimensions of resilience mediated the correlation between the confrontation coping style and complexity, respectively (P < 0.05). The strength dimension of resilience mediated the correlation between an avoidance coping style and the unpredictability of uncertainty in illness (P < 0.05), as well as correlated with resignation, complexity, and unpredictability (P < 0.05).

Resilience has moderating and mediating roles in the associations between coping style and uncertainty in illness, indicating that it is vital to improve resilience and consider positive coping styles for stroke patients in the prevention and control of uncertainty in illness.

To examine if parent illness uncertainty is indirectly associated with child depression, anxiety, and HRQOL in the CKD/SLE population. Parent-child dyads (N = 31) from outpatient rheumatology and nephrology clinics included children (ages 9-18) diagnosed with CKD (Stage 1, 2, or nephrotic syndrome) or SLE. Parents completed demographic and uncertainty measures and children completed uncertainty, depression, anxiety, and HRQOL measures. This cross-sectional study examined mediational models using the percentile bootstrapping method. Parent uncertainty had an indirect effect on child depression, anxiety, and HRQOL through the mediator, child uncertainty. In other words, parents' illness uncertainty regarding their child's condition correlates to the child's illness uncertainty, which then is associated with the child's mental health and wellbeing. Reverse mediations illustrated that parent uncertainty did not mediate child uncertainty and outcome variables. Results extend previous research by examining parent and child illness uncertainty in understudied conditions (CKD/SLE) and the relationship to outcome variables commonly related to depression (e.g., anxiety and HRQOL). Findings allow health psychologists and medical personnel to understand the impact of uncertainty on the child's wellbeing and HRQOL. Clinical implications, including using specialized interventions to address illness uncertainty, are discussed.

Uncertainty in illness implies no meaning has been attributed to an illness event. Although many studies focus on this issue in adults, there is limited research into children with chronic illnesses. Parental uncertainty has been associated with increased risk of post-traumatic stress, which can in turn adversely affect child and parent coping strategies.

To identify the characteristics of parents who are at greater risk of uncertainty and the associated characteristics of their children's chronic illnesses.

An exploratory, cross-sectional study design was adopted across three different sites in the United Arab Emirates. Data were collected from parents who accompanied their children, who were receiving treatment, using a validated, culturally adapted Parent Perception of Uncertainty Scale.

Scores for illness uncertainty ranged from 86.5 to 92.6, on a scale of 31-155, with higher scores indicating greater uncertainty. The highest scores were found in parents of children being cared for in ward settings who had previously been hospitalised, parents of children up to two years of age or those approaching adolescence, fathers, and parents whose first language was Arabic.

The groups of parents with the highest illness uncertainty may benefit most from interventions to improve communication and psychological support.