Abstract
Background: Patients tend to develop a sense of uncertainty when they lack control over the progress of the disease, and physical discomforts. The sense of uncertainty that patients develop when facing their disease or treatment may elicit physical and psychological distress which can influence the patients’ coping behaviors. Purpose: This study investigated the relationships between cirrhotic patients’ sense of uncertainty and coping behaviors. Methods: A cross-sectional, correlational research design was used. Convenience sampling was performed to select 76 cirrhotic inpatients in the division of gastroenterology at a hospital in Southern Taiwan. Three structured questionnaires (Personal Characteristics Questionnaire, Mishel Uncertainty in Illness Scale, Coping Behaviors Scale) were used for data collection. Results: (a) Cirrhotic patients perceived a moderate or increased level of uncertainty and problemoriented coping behaviors were the most frequently used coping behaviors. (b) Patients who had no religion, who had fatigue or severe disease conditions exhibited comparatively high levels of uncertainty. (c) Patients who were singled or unemployed, or fatigue often showed emotion-oriented coping behaviors. Consuming alcohol frequency, illness severity was positively correlated with emotionoriented coping behaviors. (d) Patients who were unemployed often exhibited problem-oriented coping behaviors. Educational level and consuming alcohol frequency were positively correlated with problemoriented coping behaviors. (e) Patients’ sense of uncertainty was positively correlated with emotion- and problem-oriented coping behaviors. Conclusions/ Implications for Practice: Since cirrhotic patients frequently exhibit emotion-oriented coping behaviors and have high level of uncertainty, nurses could encourage them to express their emotions and problems, and listen to them patiently. If patients were high levels of uncertainty, and exhibit problem-oriented coping behaviors, by spontaneously providing disease-related information and social support, they can readily adopt to their disease conditions.
Highlights
Chronic liver disease and cirrhosis rank as the ninth among the ten leading causes of death in Taiwan
Patients with cirrhosis experience physiological distress caused by the disease, which in turn leads to mental health problems [2]
These values revealed that cirrhotic patients more often engage in problem-oriented coping behavior rather than emotion-oriented coping behavior
Summary
Chronic liver disease and cirrhosis rank as the ninth among the ten leading causes of death in Taiwan. Patients with cirrhosis experience physiological distress caused by the disease, which in turn leads to mental health problems [2]. During the progression of a disease, patients frequently sense a lack of control over the participation in treatment decision making, the improvement of physical discomfort, the entire treatment process, and the acquisition of medical information. When people perceive a lack of control over matters that concern them, they tend to develop a sense of uncertainly that impacts and disturbs themselves mentally and physically [3]. Coping behavior refers to a dynamic process of selfadjustment, in which individuals alter their cognition and behavior in response to a stressful situation to alleviate their mental and physical burden [4]. Ko and Shu [5] reported that a strong sense of uncertainty reduces gynecologic inpatients’ ability to clarify questions and seek resources, thereby affecting their ability to cope with and adapt to the disease and treatment
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