Research completed after publication of Mishel’s original theory supported its application to acutely ill patients, but did not support the theory’s application to chronically ill patients or those facing recurrence of a disease in remission. These patients initially viewed uncertainty as dangerous, but over time came to accept it as an opportunity. This conflicted with Mishel’s original theory, which proposed that only individuals faced with the certainty of poor outcomes would view uncertainty as an opportunity.
Therefore, Mishel updated her work in 1990 to accommodate the response over time of chronically ill patients and those facing disease recurrence. Recognizing the cultural bias inherent in her original work, she abandoned the Western mechanistic assumption that adaptation is the single desired outcome and that uncertainty in illness is a linear trajectory.
The new model proposed that under conditions of chronic uncertainty, people move away from evaluating uncertainty as dangerous and adopt a new world view that accepts uncertainty as part of life. The reconceptualized model also introduced the concept of probabilistic thinking, or the ability to consider multiple ways of accomplishing goals. When people with chronic illnesses or disease remission accept uncertainty as part of life, they perceive it as an opportunity to grow and change.
[1 min 32 sec]
Research completed after publication of Mishel’s original theory supported its application to acutely ill patients, but did not support the theory’s application to chronically ill patients or those facing recurrence of a disease in remission. These patients initially viewed uncertainty as dangerous, but over time came to accept it as an opportunity. This conflicted with Mishel’s original theory, which proposed that only individuals faced with the certainty of poor outcomes would view uncertainty as an opportunity.Therefore, Mishel updated her work in 1990 to accommodate the response over time of chronically ill patients and those facing disease recurrence. Recognizing the cultural bias inherent in her original work, she abandoned the Western mechanistic assumption that adaptation is the single desired outcome and that uncertainty in illness is a linear trajectory.The new model proposed that under conditions of chronic uncertainty, people move away from evaluating uncertainty as dangerous and adopt a new world view that accepts uncertainty as part of life. The reconceptualized model also introduced the concept of probabilistic thinking, or the ability to consider multiple ways of accomplishing goals. When people with chronic illnesses or disease remission accept uncertainty as part of life, they perceive it as an opportunity to grow and change.[1 min 32 sec]
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