Correlates of illness uncertainty in cancer survivors and family caregivers: a systematic review and meta-analysis

• Published in: Supportive care in cancer Vol. 31; no. 4; p. 242
• Main Authors: Guan, Ting, Chapman, Mimi V., de Saxe Zerden, Lisa, Sharma, Anjalee, Chen, Ding-Geng, Song, Lixin
• Format: Journal Article
• Language: English
• Published: Berlin/Heidelberg Springer Berlin Heidelberg 01.04.2023; Springer; Springer Nature B.V
• Subjects: Adult; Cancer; Cancer survivors; Cancer Survivors - psychology; Caregivers; Caregivers - psychology; Cross-Sectional Studies; Humans; Male; Medicine; Medicine & Public Health; Meta-analysis; Neoplasms; Nursing; Nursing Research; Oncology; Oncology, Experimental; Pain Medicine; Quality of life; Quality of Life - psychology; Rehabilitation Medicine; Review; Sociodemographics; Systematic review; Uncertainty; Illness uncertainty; Cancer survivors; Systematic review; Family caregiver; Meta-analysis; Quality of life
• ISSN: 0941-4355; 1433-7339; 1433-7339
• DOI: 10.1007/s00520-023-07705-7

Purpose Illness uncertainty is widely recognized as a psychosocial stressor for cancer survivors and their family caregivers. This systematic review and meta-analysis aimed to identify the sociodemographic, physical, and psychosocial correlates that are associated with illness uncertainty in adult cancer survivors and their family caregivers. Methods Six scholarly databases were searched. Data synthesis was based on Mishel’s Uncertainty in Illness Theory. Person’s r was used as the effect size metric in the meta-analysis. Risk of bias was assessed using the Quality Assessment Tool for Observational Cohort and Cross-Sectional Studies. Results Of 1116 articles, 21 articles met the inclusion criteria. Of 21 reviewed studies, 18 focused on cancer survivors, one focused on family caregivers, and 2 included survivors and family caregivers. Findings identified distinct correlates for illness uncertainty in cancer survivors, including sociodemographic factors (e.g., age, gender, race), stimuli frame (e.g., symptom, family history of cancer), structure providers (e.g., education), coping, and adaptation. Notable effect sizes were observed in the correlations between illness uncertainty and social support, quality of life, depression, and anxiety. Caregivers’ illness uncertainty was associated with their race, general health, perception of influence, social support, quality of life, and survivors’ prostate-specific antigen levels. Insufficient data precluded examining effect size of correlates of illness uncertainty among family caregivers. Conclusion This is the first systematic review and meta-analysis to summarize the literature on illness uncertainty among adult cancer survivors and family caregivers. Findings contribute to the growing literature on managing illness uncertainty among cancer survivors and family caregivers.