A Concept Analysis of Uncertainty in Epilepsy

Juna Lee; Insook Lee

doi:10.4040/jkan.2017.47.4.499

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Lee and Lee: A Concept Analysis of Uncertainty in Epilepsy

Original Article

J Korean Acad Nurs 2017;47(4):499-513.

Published online: 15 January 2017

DOI: https://doi.org/10.4040/jkan.2017.47.4.499

A Concept Analysis of Uncertainty in Epilepsy

Juna Lee, Insook Lee

College of Nursing, Seoul National University, Seoul, Korea

Address reprint requests to : Lee, Insook College of Nursing, Seoul National University, 103 Daehak-ro, Jongno-gu, Seoul 03080, Korea Tel: +82-2-740-8828 Fax: +82-2-765-4103 E-mail: lisook@snu.ac.kr

Received 13 March 2017 Revised 15 July 2017 Accepted 17 July 2017

This is an Open Access article distributed under the terms of the Creative Commons Attribution NoDerivs License. (http://creativecommons.org/licenses/by-nd/4.0) If the original work is properly cited and retained without any modification or reproduction, it can be used and re-distributed in any format and medium.

Abstract

Purpose

This concept analysis was done to clarify ‘uncertainty in epilepsy’.

Methods

Walker and Avant's methodology guided the analysis. In addition, the concept was compared with uncertainty in other health problems.

Results

‘Uncertainty in epilepsy’ was defined as being in the condition as seen from the epilepsy experience where cues were difficult to understand because they changed, were in discord with past ones, or they had two or more contradictory values at the same time. Uncertainty in epilepsy is evolved from appraisal of the epilepsy experience. As a result, uncertainty leads epilepsy patients, their family or health care providers to impaired functioning and proactive/passive coping behavior.

Conclusion

Epilepsy patients with uncertainty need to be supported by nursing strategies for proactive, rational coping behavior. This achievement has implications for interventions aimed at changing perception of epilepsy patients, their families or health care providers who must deal with uncertainty.

Keywords: Epilepsy, Uncertainty

References

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Table 1.

Searching Strategies Applied to Internet Database

Database	Search engine	The number of items	Entry terms
RISS	RISS	4	((뇌전증) OR (간질)) AND (불확실성)
MEDLINE	PubMed	249	(((((Epilepsy[MeSH Terms]) OR Epilep*[Title/Abstract]) OR Seizures[MeSH Terms])
			OR Seizure[Title/Abstract])) AND ((Uncertainty[MeSH Terms] OR Uncertainty[Title/
			Abstract])
CINAHL	EBSCO	103	Limiters: Full Text; English Language; Exclude MEDLINE records; Human; PDF Full Text
			Search Modes: Smart Text Searching; Boolean/Phrase (MH Uncertainty OR AB
			Uncertainty) AND (MH seizures OR MH Epilepsy OR AB Epilep* OR AB Seizure*)
EMBASE	EMBASE	524	#1 AND #2
			#1 ‘seizures’/exp OR seizure:ab,ti OR epilep*:ab,ti OR ‘epilepsy’/exp
			#2 uncertainty:ab,ti OR ‘uncertainty’/exp

Table 2.

Dimensions and Defining Attributes of Uncertainty in Epilepsy Patients

Defining attribute	Meaning
Ambiguity	The inability to place an event within a comprehensive gestalt
Complexity	The inability to distinguish between one treatment and another
Inconsistency	The information received from the health care provider changes frequently or is different from the previous one
Unpredictability	Concern about the health care process and its consequences because the current illness experience is inconsistent with
	the previous one
Coexistence	Difficulties in judging epilepsy experience because it has two or more contradictory values at the same time

Table 3.

Antecedents and Consequences of Uncertainty in Epilepsy Patients

Antecedents		Components
Appraisal of epilepsy experience	Symptom pattern	Period, Severity, Frequency, Probability
	Event familarity	Post experience, Information, Knowledge
Consequences		Components
Impaired functioning	Physical function	Dysfunction of physiological activity
	Affective function	Fatigue, Loneliness, Fear, Frustration, Anxiety
Difficulties in making a decision		-
Coping behavior	Proactive	Mastering skills, Decision-making, Gathering information, Adherence OR Non-
		compliance, Decision under risk, Over-treatment, Balance between risk and
		quality of life, Doing what I can do for the best outcome, Struggle to manage
		a constant feeling of uncertainty
	Passive	Acceptance, Preoccupation, Protracting decision, Unrealistic observation, Cost-effective approach, Ignorance, Vigilance, Denial, Concealment

Table 4.

Comparison with Uncertainty in Other Health Problems

Attribute of Uncertainty	Health Problems
	Illness	Epidemic	Pain	Diabetes Mellitus	Epilepsy	Lung Cancer
Ambiguity	○	○	○	○	○	○
Complexity	○	○	○	○	○	○
Inconsistency	○	○	○	○	○	○
Unpredictability	○	○	○	○	○	○
Coexistence	×	×	×	×	○	×
Transmissibility	×	○	×	×	×	×
Subjectivity	×	×	○	×	×	×

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