Uncertainty In Illness Theory Research Articles

Development of Theory of Uncertainty on COVID-19: Theory Derivation Based on Uncertainty in Illness Theory

Purpose: The purpose of this study is to develop the Theory of Uncertainty on COVID-19 using the strategy of theory derivation. Methods: Theory derivation was carried out in the following steps: review the literature to explore the phenomena related to uncertainty on COVID-19; select a parent theory that provides valuable concepts and a useful structure for derivation, and identify the concepts and structure of the parent theory to use in derivation; modify and redefine the concepts and structure of the parent theory to create a derived theory. In the literature review process, relevant findings were synthesized to support the propositions of the derived theory. Results: The Theory of Uncertainty on COVID-19 was derived from the Uncertainty in Illness Theory to make it relevant and applicable to a specific aspect of uncertainty on COVID-19, health-related uncertainty perceived by a person who has not contracted COVID-19. It is a middle-range theory targeting the general population and consists of a linear and unidirectional model centered on three themes: antecedents of uncertainty, appraisal of uncertainty, and coping with uncertainty. Conclusion: The Theory of Uncertainty on COVID-19 will be able to contribute to efforts to manage perceived uncertainty on pandemic diseases and improve individual biopsychosocial health in the future.

Navigating chronic uncertainty: a theory synthesis for nursing communication in life-limiting illness

BackgroundDespite 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.MethodTurner’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.ResultsThis 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.DiscussionThe 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.

The relationship between uncertainty in illness and psychological adjustment to chronic illness.

Using Mishel's Uncertainty in illness theory, this integrative review sought to identify how uncertainty in illness and psychological adjustment to illness are associated with chronic illness to guide development of interventions to support psychological adjustment. A search was conducted via EBSCOHost to answer the question "What is the relationship between uncertainty in illness and psychological adjustment to chronic illness?" Two key factors were identified as having an impact on psychological adjustment to chronic illness in the presence of uncertainty in illness including uncertainty appraisal and the type of coping strategies used in response to the appraisal. Individuals with a chronic illness diagnosis are more likely to experience increased levels of uncertainty in illness and decreased psychological adjustment to illness. A better understanding of these two concepts is important to augment and or guide the development of interventions to support psychological adjustment.

Work injuries and mental health challenges: A meta‐analysis of the bidirectional relationship

AbstractThe link between work injuries and mental health challenges significantly impacts individuals, organizations, and society. However, an integrated understanding of their relationship is lacking due to fragmented research across various disciplines. Drawing from uncertainty in illness theory, our comprehensive meta‐analysis (147 samples, N = 1,457,562) clarifies the bidirectional relationship between work injuries and mental health challenges. We estimate the average strength of the association, compare temporal ordering (work injuries preceding mental health challenges, and vice versa), explore underlying mechanisms, and identify potential moderating factors. Results from a random‐effects model reveal a moderate association between work injuries and mental health challenges (k = 147, ρ = .21, 95% CI = .19, .24, 95% CR = −.11, .50). Notably, the relationship is stronger when work injuries precede mental health challenges (k = 40, ρ = .23, 95% CI = .18, .29, 95% CR = −.10, .52) compared to the reverse (k = 18, ρ = .11, 95% CI = .03, .19, 95% CR = −.23, .42). Negative cognitions and perceived job demand underlie the bidirectional relationships between work injuries and mental health challenges. These findings highlight the interconnected nature of work injuries and mental health challenges, illustrating the need for comprehensive rehabilitation approaches that integrate physical and psychological care, and paving the way for future research and interventions.

Refining Mishel's Reconceptualized Uncertainty in Illness Theory: Explaining the Development of Uncertainty in Chronic Illness.

Background and Purpose: Mishel's Reconceptualized Uncertainty in Illness Theory describes the changed, more positive appraisal of uncertainty over time in a chronic disease. Therefore, Mishel referred to "probabilistic thinking" and "self-organization." The description of these concepts remained highly abstract, limiting the understanding of how change of uncertainty comes about. We aimed to elaborate on this gap and at refining the theory. Methods: We conducted a study consisting of three parts: (a) concept analyses of "probabilistic thinking" and "self-organization," (b) longitudinal qualitative study to investigate uncertainty experience over time, and (c) triangulation of (a) and (b) to develop theoretical propositions. Results: We developed five theoretical propositions in syllogistic form: (a) if persons experience uncertainty, they think probabilistically to assess the existentiality of potential consequences, (b) if they expect existential consequences, they experience uncertainty as a threat, (c) if the existentiality of uncertainty diminishes, then individuals accept uncertainty as an inherent part of illness, (d) if they accept uncertainty, they cognitively reframe it in a positive way in order to promote recovery, and (e) if persons reexperience uncertainty, they reassess the existentiality of potential consequences. Implications for Practice: We propose "health belief" as a mechanism driving "cognitive reframing" to explain the interrelation between uncertainty and a more positive experience. "Existential uncertainty" offers a new perspective on preventing a change in uncertainty experience. The new concepts can provide guidance to take measures to reduce existential uncertainty and promote health beliefs to change the experience of uncertainty from a negative to a more positive one.

Integrative Stress Perception Interventions for Leukemia Patients: A Multidisciplinary Approach

BACKGROUND: Leukemia patients often face significant psychological stress due to the uncertainty of their disease’s outcome, the side effects of treatment, and the profound changes to their lives. Effective stress management interventions are crucial for improving their quality of life and psychological well-being. OBJECTIVE: This article aims to explore and evaluate the theoretical frameworks and practical interventions for managing stress perception in leukemia patients, providing an integrated view of the current methodologies and their outcomes. METHODS: We review and synthesize the literature on stress perception interventions within leukemia care, focusing on mindfulness theory, cognitive behavioral theory, and the theory of uncertainty in illness. We assess the efficacy of various interventions, including mindfulness-based stress reduction, cognitive behavioral therapy, stress inoculation training, and graded interventions, alongside the utilization of measurement tools such as the Perceived Stress Scale (PSS) and the Perceived Stress Questionnaire (PSQ). RESULTS: The reviewed interventions demonstrate significant potential in reducing stress perception among leukemia patients. Mindfulness-based approaches help patients focus on the present and reduce rumination, cognitive behavioral interventions address negative thought patterns contributing to stress, and graded interventions tailor care to individual patient needs. Furthermore, the application of stress measurement tools provides a quantitative basis for evaluating intervention efficacy. CONCLUSION: Integrative stress management interventions, grounded in comprehensive theoretical frameworks, offer significant benefits for leukemia patients, contributing to lower stress levels and improved overall well-being. Healthcare providers are encouraged to incorporate these interventions into standard leukemia care, ensuring a holistic approach to patient treatment. Future research should aim to innovate and refine these interventions, ensuring they are accessible, feasible, and effective for the diverse leukemia patient population.

Supporting the support person: Oncologists' roles in reducing support people's uncertainty and facilitating psychological adjustment.

Support people of cancer patients are at significant risk for psychological distress. Additionally, cancer patients' well-being is reciprocally associated with support peoples' psychological well-being. Informed by Uncertainty in Illness Theory, this study tests whether support person psychological well-being is influenced by provider communication and uncertainty reduction. We tested a multiple mediation model to investigate how empathic communication facilitates psychological adjustment in support people of cancer patients and how this process is mediated by support peoples' illness uncertainty and caregiver burden. Support people of cancer patients (N=121; including spouses, adult children, etc.) completed an online questionnaire about their perceptions of oncologists' empathy, uncertainty about the cancer patients' illness, perceived caregiving burden, and their psychological adjustment to diagnoses. Path analysis revealed that (1) more perceived oncologist empathy was associated with less illness uncertainty, (2) more illness uncertainty was associated with worse psychological adjustment and more perceived caregiver burden, and (3) more burden was associated with worse adjustment (χ2 (2)=1.19, p=0.55; RMSEA < 0.01; CFI=1.00; SRMR=0.02). Given the reciprocal nature of well-being between cancer patients and their support people, it is critical to understand and bolster support people's psychological well-being. Results demonstrated how empathic provider communication can support psychological well-being for support people of cancer patients. Additionally, this study offers theoretical contributions to understandings of illness uncertainty in caregiver populations.

Analysis Of The Application Of Merle H. Mishel's Theory: Uncertainty In Illness Theory In Patients With Colon Cancer Cases

Introduction: Mishel's Theory of Uncertainty in Illness offers insights into how patients navigate uncertainty in health contexts. This study examines its application in individuals with colon cancer.Methods: Literature review and case study analysis were employed to explore Mishel's theory's relevance in colon cancer care.Results: Mishel's theory provides a framework for understanding and addressing uncertainty among colon cancer patients. Nursing interventions focusing on education, social support, and coping strategies facilitate patient adaptation.Conclusion: Mishel's Theory of Uncertainty in Illness enhances nursing practice by guiding interventions tailored to address uncertainty in colon cancer patients. Integrating this framework fosters patient understanding and coping, ultimately improving quality of care and patient outcomes.

From existential uncertainty to a new mindset promoting recovery: Exploring the development of uncertainty experience in women with vulvar neoplasia – A qualitative longitudinal study

BackgroundWomen with vulvar neoplasia continue to experience uncertainty up to six months post-surgery. Uncertainty in illness is considered a significant psychosocial stressor, that negatively influences symptom distress, self-management strategies and quality of life. According to the Reconceptualized Uncertainty in Illness Theory, the appraisal of uncertainty changes positively over time in chronic illness. We aimed at exploring whether and how the experience of uncertainty develops in women with vulvar neoplasia.MethodsWe selected a purposive sample of seven women diagnosed with vulvar neoplasia in four Swiss and one Austrian women’s clinic. By means of a qualitative longitudinal study, we conducted 30 individual interviews at five points of time during one year after diagnosis. We applied Saldaña’s analytical questions for longitudinal qualitative research.ResultsFirst, participants experienced uncertainty as an existential threat, then an inherent part of their illness, and finally a certainty. Women initially associated the existential threat with a high risk for suffering from severe health deteriorations. Participants that could reduce their individually assessed risk by adopting health promoting behaviors, accepted the remaining uncertainty. From now on they reframed uncertainty into a certainty. This new mindset was based on a belief of promoting recovery and reducing the risk of recurrence.ConclusionsThe long-lasting and oscillating nature of uncertainty should receive attention in supportive oncology care. Uncertainty concerning existential issues is of special importance since it can inhibit a positive development of uncertainty experience.

Uncertainty in surrogate decision-making about end-of-life care for people with dementia: An integrative review.

To describe uncertainty in surrogate decision-making regarding end-of-life care for people with dementia using Mishel's reconceptualized uncertainty in illness theory. Integrative literature review using Whittemore and Knafl's approach. PubMed, CINAHL, EMBASE, Scopus and Web of Science were searched using terms such as uncertainty/unpredictability, decision-making/advance care planning/end-of-life care planning, surrogate/family/caregiver/proxy and dementia. The search was initially conducted on 28 September 2021 and updated on 31 July 2023. Through systematic screening, 20 research articles were included in the analysis. Content related to uncertainty in surrogate decision-making regarding end-of-life care was extracted and analysed, focusing on the reconceptualized uncertainty in illness theory. First, surrogate uncertainty exists in various areas of surrogate decision-making regarding end-of-life care. Second, antecedents of surrogate uncertainty include numerous intrinsic and extrinsic factors. Third, surrogates exhibited some negative psychological responses to uncertainty but continually processed and structured their uncertainty through certain approaches, leading them to grow as decision-makers. Finally, research-based evidence on surrogates' processing of uncertainty and shifts to new life perspectives remains limited. Surrogates' uncertainty in decision-making regarding end-of-life care for people with dementia is well characterized using the reconceptualized uncertainty in illness theory. Healthcare providers should help surrogates manage their uncertainty in surrogate decision-making more constructively throughout the dementia trajectory. The findings highlight the importance of assessing how surrogates process uncertainty and gauging how to help them process uncertainty and transition to new life perspectives. This review contributes to healthcare professionals' understanding of surrogates' uncertainty in end-of-life care planning for people with dementia, especially what they are uncertain about, what influences their uncertainty and how they process it. This study adheres to the PRISMA reporting guidelines. No patient or public contribution.

Influence of Illness Uncertainty on Health Behavior in Individuals with Coronary Artery Disease: A Path Analysis.

This study aimed to investigate the influence of uncertainty-related factors on the health behavior of individuals with coronary artery disease (CAD) based on Mishel's uncertainty in illness theory (UIT). We conducted a cross-sectional study and path analysis to investigate uncertainty and factors related to health behavior. The study participants were 228 CAD patients who visited the outpatient cardiology department between September 2020 and June 2021. We used SPSS 25.0 and AMOS 25.0 software to analyze the data. The final model demonstrated a good fit with the data. Eleven of the twelve paths were significant. Uncertainty positively affected danger and negatively affected self-efficacy and opportunity. Danger had a positive effect on perceived risk. Opportunity positively affected social support, self-efficacy, perceived benefit and intention, whereas it negatively affected perceived risk. Social support, self-efficacy, perceived benefit and intention had a positive effect on health behavior. We found that perceived benefit and intention had the most significant direct effects, whereas self-efficacy indirectly affected the relationship between uncertainty and health behavior. The path model is suitable for predicting the health behavior of CAD patients who experience uncertainty. When patients experience uncertainty, interventions to increase their self-efficacy are required first. Additionally, we need to develop programs that quickly shift to appraisal uncertainty as an opportunity, increase perceived benefits of health behavior, and improve intentions.

Uncertainties experienced by nursing professionals who contracted Covid-19: a priori, everyone is human.

To analyze the uncertainties experienced by nursing professionals who contracted COVID-19. This qualitative research was conducted with 20 nursing professionals who fell ill from COVID-19. Data collection was carried out through semi-structured interviews; the data were then organized using thematic analysis and discussed in the context of Merle Mishel's Reconceptualized of Uncertainty in Illness Theory. The antecedents of the disease had a strong influence on how nursing professionals who contracted COVID-19 perceived uncertainty. The media coverage of the increasing number of cases, the collapse of the healthcare system, and the high mortality rate contributed to associating the disease with fear and panic. Viewing it from the perspective of the disease's antecedents, the illness of a nursing professional from COVID-19 underscores that before being professionals, they are human beings just like anyone else, undergoing adversities and facing the possibilities associated with being ill.

Efecto de una intervención enfermera sobre la incertidumbre de familiares en Cuidado Intensivo

Introduction: Family members of patients admitted to an Intensive Care Unit present high uncertainty level due to not knowing what is happening and to not having clear details about the related events; therefore, interventions are required to allow modulating those levels. Objective: To evaluate the effect of an educational Nursing intervention compared to conventional care on the uncertainty of family members of patients hospitalized in an ICU. Materials and methods: An experimental study with a sample comprised by 132 relatives of patients admitted to an ICU, randomly distributed in four Solomon groups (33 in each group). The Nursing intervention based on the concepts of the Uncertainty in Illness Theory was applied to both experimental groups and devised under the Whittemore and Grey parameters with three moments: assessment; education about the relative's hospitalization in the ICU; and accompaniment. This was done with pre-assessments for two groups and post-assessments for the four groups, using the PPUS-FM Uncertainty Scale. The data were analyzed by means of descriptive statistics and respective non-parametric analyses. The study took into account the ethical principles in research. Results: The family members in the experimental groups presented a lower final uncertainty level when compared to the control groups, with a difference of 73.04 points and a p-value of 0.001. Discussion: Standardized interventions and under a theoretical model allow reducing uncertainty in relatives of patients in ICUs. Conclusions: The Nursing intervention based on the Uncertainty theory allows reducing uncertainty in relatives of patients hospitalized in an Intensive Care Unit.

The Unknown Journey: Uncertain Experiences in Mothers of Infants With Congenital Heart Disease Before Undergoing Open Heart Surgery

Most children with complex congenital heart disease (CHD) require open-heart surgery within one year of birth to survive. Thus, new mothers of infants with CHD are faced with making unexpected and difficult decisions. This study was designed to explore the essence of the maternal uncertain experience prior to infants with CHD undergoing open-heart surgery. In this study, a phenomenological approach was used and data were collected using open-ended interview guidelines structured around the Uncertainty in Illness Theory. Nine mothers of infants with CHD who had received open-heart surgery were interviewed in a hospital interview room within two weeks the operation. Colaizzi's (1978) data processing procedure was applied in the post-interview analysis. Five themes emerged: (1) Hit bottom and felt helpless; (2) Hit the road - An overwhelming sense of emergency; (3) The crunch - Do your best to accept destiny (4) Disease brought the unknown; (5) Hope in uncertainty. The high-risk nature of and their unfamiliarity with the surgery made the participants experience illness uncertainty. The medical system should develop more-structured CHD information and provide emotional support in a timely manner to alleviate illness uncertainty in mothers of infants with CHD.

The Effects of Coping Strategies Between Uncertainty and Quality of Life of Korean Women With Gynecological Cancer: Evaluation of Uncertainty in Illness Theory and Stress and Coping Theory.

The objective of this study was to explore the mediation effects of coping strategies on the relationship between uncertainty and quality of life in Korean women with gynecological cancer. Mishel's Uncertainty in Illness Theory and Lazarus and Folkman's Stress and Coping Theory were used to guide the study. Three coping strategies (problem-focused, active emotional, and avoidant emotional) partially mediated the relationship between uncertainty and quality of life. This work provides evidence that reducing uncertainty has significant effects on coping strategies and positively affects the quality of life in women with gynecological cancer.

Facilitating psychological adjustment for breast cancer patients through empathic communication and uncertainty reduction

ObjectivesThis study examined the degree to which breast cancer patients’ psychological well-being is facilitated through empathic provider communication. We explored symptom/prognostic uncertainty reduction as a mechanism through which provider communication influences patient psychological adjustment. Additionally, we tested if treatment status moderates this relationship. MethodsInformed by uncertainty in illness theory, current (n = 121) and former (n = 187) breast cancer patients completed questionnaires about perceptions of their oncologists’ empathy and their symptom burden, uncertainty, and adjustment to their diagnosis. Structural equation modeling (SEM) was conducted to test hypothesized relationships between perceived provider empathic communication, uncertainty, symptom burden, and psychological adjustment. ResultsSEM supported the following: (1) higher symptom burden was associated with increased uncertainty and reduced psychological adjustment, (2) lower uncertainty was associated with increased adjustment, and (3) increased empathic communication was associated with lower symptom burden and uncertainty for all patients (χ2(139) = 307.33, p < .001; RMSEA = .063 (CI .053, .072); CFI = .966; SRMR = .057). Treatment status moderated these relationships (Δχ2 = 264.07, Δdf = 138, p < .001) such that the strength of the relationship between uncertainty and psychological adjustment was stronger for former patients than for current patients. ConclusionsResults of this study reinforce the importance of perceptions of provider empathic communication as well as the potential benefits of eliciting and addressing patient uncertainty about treatment and prognosis throughout the cancer care continuum. Practice ImplicationsPatient uncertainty should be a priority for cancer-care providers both throughout and post-treatment for breast cancer patients.

Uncertain and Anxiously Searching for Answers: The Roles of Negative HealthCare Experiences and Medical Mistrust in Intentions to Seek Information from Online Spaces

ABSTRACT While online sources of information, like support groups and wellness influencers, can be beneficial for those seeking additional information about their health conditions, these sources can also contain detrimental information. As misinformation and even conspiracies like QAnon proliferate in wellness discourse, particularly in online support groups and on the accounts of wellness influencers, it becomes increasingly important to understand what may contribute to individuals seeking information from these sources. Based on uncertainty in illness theory and the theory of motivated information management, we conducted a cross-sectional survey (N = 544) to test the role of negative health-care experiences and medical mistrust in uncertainty and information seeking from online support groups and wellness influencers across those with chronic and acute health concerns. Results indicated that negative health-care experiences had an indirect effect on information seeking from both online support groups and wellness influencers. This indirect effect, however, operated through uncertainty anxiety but not uncertainty discrepancy. For those with chronic conditions, the indirect effect also included medical mistrust. Implications and future extensions of the results are discussed.

Correlates of illness uncertainty in cancer survivors and family caregivers: a systematic review and meta-analysis.

Illness uncertainty is widely recognized as a psychosocial stressor for cancer survivors and their family caregivers. This systematic review and meta-analysis aimed to identify the sociodemographic, physical, and psychosocial correlates that are associated with illness uncertainty in adult cancer survivors and their family caregivers. Six scholarly databases were searched. Data synthesis was based on Mishel's Uncertainty in Illness Theory. Person's r was used as the effect size metric in the meta-analysis. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Of 1116 articles, 21 articles met the inclusion criteria. Of 21 reviewed studies, 18 focused on cancer survivors, one focused on family caregivers, and 2 included survivors and family caregivers. Findings identified distinct correlates for illness uncertainty in cancer survivors, including sociodemographic factors (e.g., age, gender, race), stimuli frame (e.g., symptom, family history of cancer), structure providers (e.g., education), coping, and adaptation. Notable effect sizes were observed in the correlations between illness uncertainty and social support, quality of life, depression, and anxiety. Caregivers' illness uncertainty was associated with their race, general health, perception of influence, social support, quality of life, and survivors' prostate-specific antigen levels. Insufficient data precluded examining effect size of correlates of illness uncertainty among family caregivers. This is the first systematic review and meta-analysis to summarize the literature on illness uncertainty among adult cancer survivors and family caregivers. Findings contribute to the growing literature on managing illness uncertainty among cancer survivors and family caregivers.

Living with pulmonary sequelae of COVID-19 and the implications for clinical nursing practice: A qualitative systematised review.

To synthesise qualitative research on pulmonary sequelae of COVID-19 and identify patient needs and experiences to develop nursing care strategies. Qualitative research on long COVID by subtype has not yet occurred. As pulmonary sequelae constitute a serious long COVID subtype, exploring patient experience and needs can generate knowledge to guide nursing practice. Systematised review methodology utilised on a purposive sample of published articles and reported using the PRISMA guidelines and checklists. Searched MEDLINE, Cumulative Index to Nursing and Allied Health, and Google Scholar, for English or French articles published from February 2020 to June 2022; qualitative research with adults recovering from COVID-19 with evidence of pulmonary sequelae. Established principles for data extraction followed related to data reduction, data presentation, data comparison, and conclusion formulation and verification. Analysis was informed by Thorne's Interpretive Description and extended with Meleis' transitions theory, Mishel's uncertainty in illness theory and Moore et al.'s holistic theory of unpleasant symptoms. The quality of included studies was assessed Joanna Briggs Institute critical appraisal tool for qualitative research. Four articles with six pooled participants provided data to yield three main themes: (1) a novel health-illness transition, (2) lung injury and pulmonary fibrosis as antecedent to illness uncertainty, (3) and pulmonary symptoms that are compounded by fatigue and weakness. Pulmonary sequelae of COVID-19 confers a unique health-illness transition, uncertainties and symptoms that can be addressed by theory informed nursing practice. Advocacy, optimising the nurse-patient relationship, offering up-to-date information and addressing uncertainty may help patients cope with pulmonary sequelae, a complex subtype of long COVID with important considerations for clinical nursing care. Despite a lack of evidence-informed clinical pathways, nurses can support patients to understand novel treatments, support discharge planning and acknowledge the synergistic nature of pulmonary symptoms and fatigue to support health-illness transitions. This article involved analysis of previously published works.

A new landscape in illness uncertainty: A systematic review and thematic synthesis of the experience of uncertainty in patients with advanced cancer receiving immunotherapy or targeted therapy.

Over the past 20years, immunotherapy and targeted therapy (TT) have been extending the life expectancy and providing hope for a growing number of patients with advanced and metastatic cancer. However, the efficacy, side effects, and overall prognosis of these treatments are highly unpredictable. Recent research suggests that these patients may be experiencing significant uncertainty which impacts their functioning. This study reviewed the literature on the experiences of uncertainty for individuals with advanced or metastatic cancer patients who are receiving immunotherapy or TT. A systematic literature review was conducted. Data was extracted from studies by pairs of reviewers. Literature quality was appraised using the Critical Appraisal Skills Program checklist. Following data extraction, thematic synthesis was used to summarize findings across studies and generate overarching themes. Fifteen qualitative studies were included. Findings highlighted impacts of various sources of uncertainty (financial, emotional, social), unmet needs related to uncertainty (practical, informational, communication), and recommendations for the management of uncertainty. Clinical implications and study limitations were indicated. Findings were situated within Mishel's Uncertainty in Illness Theory and the literature on supportive care for advanced cancer populations. Recommendations related to improving healthcare provider communication and balancing hope and expectations for treatment outcomes were highlighted. Further research is needed to investigate experiences of uncertainty in this population. Tailored interventions for uncertainty may be warranted.