Uncertainty during breast diagnostic evaluation: state of the science.
OBJECTIVE
To present the state of the science on uncertainty in relationship to the experiences of women undergoing diagnostic evaluation for suspected breast cancer.


METHODS
Published articles from Medline, CINAHL, PubMED, and PsycINFO from 1983-2008 using the following key words: breast biopsy, mammography, uncertainty, reframing, inner strength, and disruption.


RESULTS
Fifty research studies were examined with all reporting the presence of anxiety persisting throughout the diagnostic evaluation until certitude is achieved through the establishment of a definitive diagnosis. Indirect determinants of uncertainty for women undergoing breast diagnostic evaluation include measures of anxiety, depression, social support, emotional responses, defense mechanisms, and the psychological impact of events.


CONCLUSIONS
Understanding and influencing the uncertainty experience have been suggested to be key in relieving psychosocial distress and positively influencing future screening behaviors. Several studies examine correlational relationships among anxiety, selection of coping methods, and demographic factors that influence uncertainty. A gap exists in the literature with regard to the relationship of inner strength and uncertainty.


CONCLUSIONS
Nurses can be invaluable in assisting women in coping with the uncertainty experience by providing positive communication and support. Nursing interventions should be designed and tested for their effects on uncertainty experienced by women undergoing a breast diagnostic evaluation.
Montgomery
Mariann
M
School of Nursing, West Virginia University, Morgantown, USA. mmontgo5@kent.edu
D000223:Adaptation, Psychological; D001007:Anxiety / Q000523:psychology; D001294:Attitude to Health; D001943:Breast Neoplasms / Q000175:diagnosis / Q000523:psychology; D003142:Communication; D017281:Cost of Illness; D003674:Defense Mechanisms; D003863:Depression / Q000523:psychology; D005260:Female; D006801:Humans; D008016:Life Change Events; D024802:Nurse's Role; D015404:Nursing Methodology Research; D010353:Patient Education as Topic; D012107:Research Design; D012944:Social Support; D035501:Uncertainty