title: Living with uncertainty: concept advancement.
abstract: OBJECTIVE
  This paper reports a study to demonstrate how the scientific understanding of the concept of uncertainty was advanced through a phenomenological study of living with uncertainty.
  
  
  BACKGROUND
  Techniques for concept analysis have evolved to subsume strategies for advancing a concept towards greater clarity and utility for research and practice. Recently, it has been argued that a clear delineation of techniques for concept analysis as separate and distinct from techniques of concept advancement is warranted. This article applies such delineated processes to demonstrate the advancement of the concept of uncertainty.
  
  
  METHODS
  Concept analysis was used to establish an integrated understanding of the state of the science. Gaps in understanding were carefully analysed, resulting in the research question guiding the next phase of concept advancement: what is the nature of the lived experience of uncertainty? A phenomenological investigation of the experience of uncertainty among family caregivers was conducted. Then, using methods of template comparison, the conceptual attributes identified through the phenomenological study were compared and contrasted with the theoretical definition derived through concept analysis. Finally, a new conceptual definition of higher order abstraction, with greater pragmatic utility, was derived.
  
  
  RESULTS
  Uncertainty is rooted in the individual's perception of outcomes or meaning of a situation. Such perceptions challenge one's sense of confidence and/or control to yield varied types and modes of uncertainty. Uncertainty is present oriented. Both cognitive and precognitive ways of knowing are influential in ascribing meaning, anticipating outcomes and adapting strategies.
  
  
  CONCLUSIONS
  One's sense of confidence and sense of control are primary essences that determine the nature of the experience of uncertainty. The experience of living with uncertainty is dynamic, with fluctuations in the types and modes of uncertainty in response to precognitive and cognitive ways of knowing. Probabilistic paradigms preclude existential and situational modes of uncertainty for which probabilities cannot be appreciated.
authors.affiliation: Nursing College of Health and Human Development and Assistant Professor of Humanities College of Medicine, The Pennsylvania State University, PA, USA. jlp198@psu.edu
authors.forename: Janice
authors.initials: J
authors.lastname: Penrod
mesh_terms: D000223:Adaptation, Psychological; D017028:Caregivers / Q000523:psychology*; D006801:Humans; D008960:Models, Psychological; D015399:Nursing Research / Q000379:methods*; D009742:Nursing Theory; D035501:Uncertainty