Test of a conceptual model of uncertainty in children and adolescents with cancer†
Article first published online: 12 MAR 2010
Copyright © 2010 Wiley Periodicals, Inc.
Research in Nursing & Health
Volume 33, Issue 3, pages 179–191, June 2010
How to Cite
Stewart, J. L., Mishel, M. H., Lynn, M. R. and Terhorst, L. (2010), Test of a conceptual model of uncertainty in children and adolescents with cancer. Res. Nurs. Health, 33: 179–191. doi: 10.1002/nur.20374
We wish to thank the pediatric oncology teams at Duke University Children's Hospital, Durham NC; Wake Forest University Baptist Medical Center, Winston-Salem, NC; Children's Hospital of Atlanta, GA; and University of North Carolina Hospitals, Chapel Hill, NC, for their assistance with participant recruitment. This study was conducted as part of Dr. Stewart's doctoral dissertation at the University of North Carolina at Chapel Hill School of Nursing and supported by a research grant from the Oncology Nursing Society Foundation/Amgen, Inc., pre-doctoral fellowships from the National Cancer Institute (NCI R25 CA57726-07), the National Institute of Child Health and Human Development (NIH 1 T32 HD07376-15), and the National Institute of Nursing Research (NIH 1 T32 NR07091-01), and the American Cancer Society's Doctoral Scholarship in Cancer Nursing.
- Issue published online: 17 MAY 2010
- Article first published online: 12 MAR 2010
- Manuscript Accepted: 6 FEB 2010
- parent-child relationship;
- growth and development;
Despite recognition as a significant stressor in childhood cancer, illness-related uncertainty from the perspective of children remains under-studied. We tested a conceptual model of uncertainty, derived from Mishel's uncertainty in illness theory, in 68 school-aged children and adolescents with cancer. As hypothesized, uncertainty was significantly related to psychological distress, but only one hypothesized antecedent (parental uncertainty) significantly predicted children's uncertainty. An alternative model incorporating antecedent developmental factors (age and illness-specific expertise) explained 21% of the variance in child uncertainty; controlling for stage of treatment, uncertainty was higher in children with shorter time since diagnosis, older age, lower cancer knowledge, and higher parental uncertainty. These findings provide the foundation for further studies to understand children's management of uncertainty and its contribution to psychological adjustment to illness. © 2010 Wiley Periodicals, Inc. Res Nurs Health 33:179–191, 2010