Peer review response one

250-word peer responses, references must be cited in APA format, 7th Edition, and must include a minimum of 2 scholarly resources published within the past 5 years. Acknowledge my peer’s idea, explain why you agree or disagree, and support your reasoning with scientific evidence. Text: Health has been defined in different ways over time. The World Health Organization (1948) defines health as a state of complete physical, mental and social well being, and not merely the absence of disease. Years later, this concept was expanded by understanding health as the ability of people to develop their potential and respond positively to the challenges of the environment (World Health Organization, 1986).

From the perspective of mental health, health is also related to how people face situations that affect their well-being. This perspective understands health as the integration of the body, the mind, and relationships with others. When people manage to adapt to changes, they discover their abilities and can better face the difficulties of life.

The Uncertainty in Illness Theory (UIT) was developed by Merle Mishel, a nurse with a Masters degree in Psychiatric Nursing, and explains how patients may experience uncertainty about their illness when they do not know the information, do not understand it, or when it has been provided in a confusing or insufficient way. This evidently makes it difficult for the person to understand the meaning of symptoms, diagnosis, or treatment, and may lead to stress and anxiety, but it can also influence the way the patient adapts to the illness.

Later, Mishel expanded this theory and developed the Reconceptualized Uncertainty in Illness Theory (RUIT). In this theory, she explains that this uncertainty does not always have to be negative, but it can help the patient transform their diagnosis into an opportunity to change and contribute to their personal growth, especially in chronic patients who must live with their illness for the rest of their lives.

Uncertainty and the Role of Caring in Nursing Practice

The concept of caring is a central element in nursing practice. In this context, caring does not only refer to performing clinical interventions, but also to emotional support and effective communication that we use when providing education to both the patient and their family about the illness. The two theories proposed by Mishel (1988) show that when a patient faces an illness, especially in situations of uncertainty, the caring relationship with nursing personnel can reduce anxiety, strengthen trust, and facilitate adaptation to changes in health. In this way, caring contributes not only to physical recovery, but also to emotional well-being and to a better overall health experience (Aligood, 2021).

Example of Uncertainty in an Acute Health Situation

A clear example of how uncertainty manifests in an acute situation can be observed in patients who receive a diagnosis of cancer. In many cultures, the word cancer is still associated with death, which generates fear, anxiety, and uncertainty in the patient and their family. Although the physician explains the type of cancer, the stage, and the treatment options, the patient often continues to feel overwhelmed and uncertain about the future. At this moment, the role of nursing becomes fundamental through listening, education, and support, because nurses can help the patient better understand what is happening and express their concerns.

Uncertainty can also arise when a patient presents symptoms and the physician orders diagnostic tests to rule out serious diseases. Even before receiving a definitive diagnosis, the simple fact that tests are ordered can generate anxiety and thoughts related to possible life-threatening illnesses. According to recent studies, uncertainty in illness can affect the patients psychological adaptation and quality of life, which is why nursing interventions aimed at providing clear information and emotional support are essential to help patients manage this experience (Reinken, 2023).

Personal Experience of Uncertainty in a Diagnostic Process

Uncertainty can also arise when a patient presents symptoms and the physician orders diagnostic tests to rule out serious diseases. I speak from a personal experience. Last year I consulted my gynecologist because of abnormal bleeding during one of my cycles, and after evaluating me, he ordered several tests, including an endometrial biopsy to rule out cancer. Although I understand that this type of indication is part of routine medical practice, the way the need for the test was communicated generated in me a strong feeling of uncertainty and anxiety. During those days I constantly found myself thinking about the possibility of having a serious illness. This feeling only ended when I received the negative biopsy result. This experience allowed me to understand how uncertainty can emotionally affect a patient even before having a definitive diagnosis and how more empathetic communication and greater support from health professionals, especially from nursing, could help reduce anxiety while the patient waits for answers about their health condition.

Conclusion

In conclusion, each person faces and adapts to the environment in a unique and particular way. According to the uncertainty in illness theory proposed by Mishel, the need to adopt healthy behaviors that allow us to face situations of stress and anxiety through appropriate self-care and coping strategies contributes to the process of improvement and adaptability in situations of uncertainty caused by adverse health circumstances.

Chronic diseases are increasingly becoming important indicators of morbidity and mortality. This becomes a challenge for health professionals, who must seek to implement new strategies and programs that allow a comprehensive approach to individuals.

The uncertainty experienced by a person with cancer may lead them to perceive the stressful situation they are facing in an inadequate way. The nursing professional, with the objective of helping the patient face the diagnosis in a positive manner, can support them in adapting positively to the experience they are living and especially in strengthening their desire to continue living despite having an oncological disease.

The nursing professional must become a representative figure for the person who is going through the illness process. This means not only being responsible for medical orders, medication administration, or administrative aspects, but above all being capable of establishing a therapeutic relationship from the beginning of the illness, becoming an interpreter and advocate for the patients rights and needs.

References

World Health Organization. (1948). Constitution of the World Health Organization.

World Health Organization. (1986). Ottawa charter for health promotion.

Mishel, M. H. (1988). Uncertainty in illness. Image: The Journal of Nursing Scholarship, 20(4), 225232.

Aligood, M. R. (2021). Nursing theorists and their work (10th ed.). Elsevier.

Reinken, D. N. (2023). Mishel’s uncertainty in illness theory: Informing nursing diagnoses and care planning. NANDA International Journal.