The relationships among uncertainty, seriousness of illness, social support, appraisal of uncertainty, health locus of control, and perceived health status in patients newly diagnosed with atrial fibrillation

The purpose of this study was to explore uncertainty in diagnosis, treatment, and prognosis of atrial fibrillation and to examine the relationships among uncertainty, seriousness of illness, social support, appraisal of uncertainty, health locus of control, and perceived health status in patients newly diagnosed with atrial fibrillation. The theoretical frameworks of the study were Lazarus's cognitive theory of psychological stress and coping and Mishel's middle-range nursing theory of uncertainty in illness. This study utilized a descriptive correlational and cross-sectional survey design using a face-to-face interview method. A convenience sample of 81 subjects were recruited from MetroHealth Medical Center and University Hospitals of Cleveland over 10 months. The data collected were statistically analyzed by correlational analysis, hierarchical regression analyses, and path analysis. The findings of this study indicated that uncertainty was moderately high in atrial fibrillation patients compared to other clinical populations. Among antecedents of uncertainty, higher education was significantly associated with less uncertainty (beta = -.21 to -.25). Except for tangible support, persons with greater social supports perceived less uncertainty (beta = -.25 to -.27). Individuals with greater seriousness of illness perceived greater uncertainty (beta = .30 to .33). Only internal health locus of control had a significant moderating effect on the relationship between uncertainty and appraisal of danger. Uncertainty and appraisal of danger were significantly correlated (r = .53), while the relationship between uncertainty and appraisal of opportunity was not significant. The appraisal of danger was significantly associated with low perceived health status. Among four types of social support, greater emotional support was significantly related to less anxiety; greater integration was significantly associated with better mental health, less depression, and less anxiety; and greater informational support had a significant relationship with less anxiety. However, no tangible social support explained perceived health status. Among 16 path models, 12 path models with outcomes of mental health, general health, and depression fit significantly to the data of this study and 4 path models with anxiety did not fit to the data. Based on the findings of the study, direction for nursing practice and further nursing research for patients with atrial fibrillation were suggested.