Influence of Uncertainty and Uncertainty Appraisal on Quality of Life in Prostate Cancer Patients after Prostatectomy

KeumHee Nam; YoungSook Tae; ChungSoo Kim; SangMi Lee

doi:10.5388/aon.2017.17.1.45

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Nam, Tae, Kim, and Lee: Influence of Uncertainty and Uncertainty Appraisal on Quality of Life in Prostate Cancer Patients after Prostatectomy

Original Article

Asian Oncology Nursing 2017; 17(1): 45-54.

Published online: 31 March 2017

DOI: https://doi.org/10.5388/aon.2017.17.1.45

Influence of Uncertainty and Uncertainty Appraisal on Quality of Life in Prostate Cancer Patients after Prostatectomy

KeumHee Nam¹, YoungSook Tae², ChungSoo Kim³, SangMi Lee⁴

¹Research Institute of Holistic Nursing Science, Kosin University, Busan, Korea.

²College of Nursing, Kosin University, Busan, Korea.

³Department of Urology, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

⁴Department of Urology, Asan Medical Center, Seoul, Korea.

Address reprint requests to: Tae, YoungSook. College of Nursing, Kosin University, 34 Amnam-dong, Seo-gu, Busan 49267, Korea. Tel: +82-51-990-6446, Fax: +82-51-990-3031, taehope@kosin.ac.kr

Received 2 February 2017 Revised 2 March 2017 Accepted 22 March 2017

(open-access):

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Purpose

The purpose of this study was to determine the impact of uncertainty and uncertainty appraisal on quality of life (QoL) among prostate cancer patients after prostatectomy.

Methods

A descriptive correlational study was conducted with 117 participants at a hospital in S city from October 1 to December 31, 2016. Data were analyzed using descriptive statistics, t-test, ANOVA, Pearson's correlation coefficients and stepwise multiple regression using the IBM SPSS/WIN 21.0 program.

Results

According to a multiple regression model of the factors affecting QoL among prostate cancer patients after the operation, 61% of variance (F=13.92, p<.001) was explained by metastasis, recurrence, monthly income, uncertainty, uncertainty danger appraisal, and uncertainty opportunity appraisal. And the most influential factor in the QoL was uncertainty danger appraisal (β=-.37, p<.001).

Conclusion

This study demonstrated that QoL was influenced by uncertainty, uncertainty appraisal and personal characteristics. Prostate cancer patients following prostatectomy should be provided with tailored training to improve their uncertainty opportunity appraisal. Also the educational program for reducing their uncertainty should be developed and provided to patients.

Keywords: Uncertainty, Quality of Life, Prostatic Neoplasms, Prostatectomy

Figures and Tables

Table 1

General Characteristics (N=117)

Characteristics	Categories	Categories	n (%)orM ± SD
Demographic characteristic	Age (year)	≤60	17 (14.5)
		61~70	58 (49.6)
		≥71	42 (35.9)
			67.8 ± 6.9
	Marital status	Married	113 (96.6)
	Marital status	Others	4 (3.4)
	Educational level	≤Middle school	30 (25.6)
		High school graduate	41 (35.1)
		≥College graduate	46 (39.3)
	Religion	None	52 (44.5)
		Christian	28 (23.9)
		Buddhism	22 (18.8)
		Catholic	15 (12.8)
	The number of children (n=114)	1	5 (4.4)
		2	61 (53.5)
		3	48 (42.1)
	Employment	Private business	24 (20.5)
		Office job, service job	11 (9.4)
		The professions	19 (16.2)
		The others	17 (14.5)
		None	46 (39.4)
	Monthly income (10,000 won) (n=115)	≤100	16 (13.9)
		101~200	29 (25.2)
		201~300	38 (33.1)
		≤301	32 (27.8)
Disease related characteristic	Months post treatment (month)	<3	22 (18.8)
		3~<6	16 (13.7)
		6~<12	18 (15.4)
		≥12	61 (52.1)
	Type of treatment	Op.	108 (92.3)
	Type of treatment	Op. + the others	9 (7.7)
	Perceived cancer stage	Awareness	112 (95.7)
	Perceived cancer stage	Unawareness	5 (4.3)
	Metastasis	Yes	7 (6.0)
	Metastasis	No	110 (94.0)
	Recurrence	Yes	9 (7.7)
	Recurrence	No	108 (92.3)

Op.= Operation.

Table 2

Descriptive Statistics of Uncertainty, Uncertainty Appraisal, and Quality of Life (N=117)

Variables	M ± SD	Range	Min	Max
Uncertainty	2.07 ± 0.35	1~5	1.06	3.12
Ambiguity	2.23 ± 0.60	1~5	0.62	4.31
Complexity	1.95 ± 0.47	1~5	0.86	3.29
Inconsistency	1.97 ± 0.53	1~5	0.57	3.00
Unexpectedness	2.02 ± 0.47	1~5	0.80	3.40
Uncertainty appraisal
Uncertainty danger appraisal	1.99 ± 0.81	0~5	0.00	4.13
Uncertainty opportunity appraisal	1.92 ± 0.83	0~5	0.14	4.86
Quality of life	2.40 ± 0.45	0~4	1.05	3.74
Physical well-being	3.33 ± 0.60	0~4	1.00	4.00
Social/family well-being	2.07 ± 0.63	0~4	0.29	4.00
Emotional well-being	2.23 ± 0.60	0~4	0.50	4.00
Functional well-being	2.21 ± 0.72	0~4	0.43	4.00
Additional (disease related) concerns	2.24 ± 0.50	0~4	0.92	3.75

Table 3

Differences of Quality of Life according to General Characteristics (N=117)

Characteristics	Categories	Quality of life
Characteristics	Categories	M ± SD	t or F	p	Scheffé
Age (year)	≤60^a	2.51 ± 0.62	4.34	.015	b>c
	61~70^b	2.48 ± 0.34
	≥71^c	2.24 ± 0.46
Marital status	Married	2.40 ± 0.45	0.85	.395
Marital status	Others	2.18 ± 0.38	0.85	.395
Educational level	≤Middle school	2.28 ± 0.39	1.58	.210
	High school graduate	2.41 ± 0.43
	≥College graduate	2.46 ± 0.49
Religion	None	2.36 ± 0.52	1.20	.314
	Christian	2.53 ± 0.42
	Buddhism	2.31 ± 0.36
	Catholic	2.44 ± 0.31
The number of children (N=115)	1^a	2.08 ± 0.43	5.38	.006	b>c
	2^b	2.51 ± 0.43
	3^c	2.27 ± 0.44
Employment	Private business	2.39 ± 0.40	1.16	.335
	Office job, service job	2.55 ± 0.38
	The professions	2.49 ± 0.51
	The others	2.46 ± 0.58
	None	2.30 ± 0.39
Monthly income (10,000 won)	≤100^a	2.27 ± 0.67	4.87	.003	a,c＜d
	101~200^b	2.37 ± 0.32
	201~300^c	2.28 ± 0.33
	≤301^d	2.65 ± 0.47
Months post treatment (month)	＜3	2.54 ± 0.46	1.92	.130
	3~＜6	2.53 ± 0.38
	6~＜12	2.38 ± 0.49
	≥12	2.31 ± 0.44
Type of treatment	Op.	2.41 ± 0.43	1.49	.138
Type of treatment	Op.+the others	2.18 ± 0.64	1.49	.138
Perceived cancer stage	Awareness	2.41 ± 0.45	1.06	.291
Perceived cancer stage	Unawareness	2.19 ± 0.23	1.06	.291
Metastasis	Yes	1.69 ± 0.68	−2.88	.027
Metastasis	No	2.44 ± 0.39	−2.88	.027
Recurrence	Yes	1.91 ± 0.57	−2.69	.026
Recurrence	No	2.44 ± 0.42	−2.69	.026

Op.= Operation.

Table 4

Correlation among Uncertainty, Uncertainty Appraisal, and Quality of Life (N=117)

Variables	Uncertainty	Uncertainty danger appraisal	Uncertainty opportunity appraisal	Quality of life
Variables	r (p)	r (p)	r (p)	r (p)
Uncertainty	1.00
Uncertainty danger appraisal	.36 (<.001)	1.00
Uncertainty opportunity appraisal	−.32 (.001)	−.20 (.032)	1.00
Quality of life	−.55 (<.001)	−.38 (<.001)	.44 (<.001)	1.00

Table 5

The Influencing Factors on Quality of Life (N=117)

Variables	Step 1					Multicollinearity		Step 2					Multicollinearity
Variables	B	SE	ß	t	p	Tolerance	VIF	B	SE	ß	t	p	Tolerance	VIF
(Constant)	1.45	.24		6.07	<.001			2.31	.30		7.58	<.001
Metastasis^*	0.41	.19	.24	2.50	.014	.77	1.29	0.39	.14	.20	2.80	.006	.77	1.31
Recurrence^†	0.48	.19	.26	2.51	.014	.66	1.51	0.37	.14	.20	2.61	.011	.64	1.55
Monthly income^‡	0.32	.11	.30	2.93	.004	.69	1.46	0.20	.08	.19	2.42	.018	.66	1.52
Uncertainty								−0.27	.10	−.21	−2.66	.009	.63	1.60
UDA								−0.21	.04	−.37	−5.06	<.001	.72	1.38
UOA								0.18	.04	.32	4.50	<.001	.76	1.32
R²	.35							.66
Adj. R²	.28							.61
F (p)	5.39 (<.001)							13.92 (<.001)
Durbin-Watson	1.81

SE= Standard error; VIF= Variance inflation factor; UDA= Uncertainty danger appraisal; UOA= Uncertainty opportunity appraisal.

Dummy Variable: ^*Metastasis : no (1), yes (0), ^†Recurrence : no (1), yes (0), ^‡Monthly income≥301 group (1), no (0).

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