Quality of Life, Uncertainty, and Perceived Involvement in Decision Making in Patients With Head and Neck Cancer

Purpose/Objectives: To explore the relationship among perceived involvement in decision making, uncertainty, and quality of life (QOL) in patients with head and neck cancer in pre- and post-treatment periods using Mishel's Uncertainty in Illness Theory.

Design: A prospective, correlational design.

Setting: Six outpatient clinics at urban hospitals in New York, NY.

Sample: A convenience sample of 52 adults newly diagnosed with head and neck cancer.

Methods: Data were collected by a self-administered questionnaire containing a demographic datasheet, the Functional Assessment of Cancer Therapy-Head and Neck, Mishel Uncertainty in Illness Scale (Adult), and Perceived Involvement in Care Scale, at pretreatment (Time 1) and six weeks post-treatment (Time 2).

Main Research Variables: QOL, uncertainty, perceived involvement in decision making.

Findings: Post-treatment QOL was lower than pretreatment. QOL was associated with uncertainty and employment status at Time 1 and Time 2. Uncertainty and QOL at the time of pretreatment were predictors of post-treatment QOL after controlling for unemployment, chemoradiation, and physician. Perceived involvement in decision making was not associated with uncertainty or QOL.

Conclusions: The higher a patient's pretreatment QOL, the more likely QOL remains sound after treatment.

Implications for Nursing: Additional studies, including interventional evaluations to decrease uncertainty and to maintain employment and better income, are needed. Antecedents of Mishel's Uncertainty in Illness Theory may need to be refined for patients with head and neck cancer.