Effects of Written Information and Counseling on Illness-Related Uncertainty in Women With Vulvar Neoplasia

Objectives: To determine whether written information and/or counseling decreases illness-related uncertainty in women with vulvar neoplasia.

Sample & Setting: 49 women with vulvar neoplasia from four Swiss hospitals and one Austrian hospital.

Methods & Variables: A longitudinal, multicenter, randomized phase 2 study was performed. The written information group received a set of leaflets. The counseling group received five consultations with an advanced practice nurse (APN) from diagnosis to six months postsurgery that focused on symptom self-management, healthcare services, and decision making. Uncertainty was measured as a secondary outcome five times by the Mishel Uncertainty in Illness Scale.

Results: Total uncertainty and the subscales of ambiguity, inconsistency, and unpredictability improved significantly over time within the counseling group but not within the written information group. In addition, counseling improved inconsistency over time, and total uncertainty, inconsistency, and unpredictability at distinct time points more efficiently than written information.

Implications for Nursing: Counseling can reduce illness-related uncertainty. APNs are valuable healthcare providers who promote women’s self-management and may support them in becoming more familiar with illness-related events and common symptoms during this rare disease.