Understanding the concept of uncertainty in patients with indolent lymphoma

Purpose/Objectives: To review the literature on uncertainty in cancer populations, apply this concept to patients diagnosed with indolent lymphoma, identify sources of uncertainty, and present interventions aimed at assessing and addressing the management of uncertainty. Data Sources: English-language literature related to uncertainty in adult patients with cancer, psychological distress, and non-Hodgkin lymphoma, located through electronic databases PubMed (R) and CINAHL (R), hand searches, and personal contacts. Data Synthesis: Review of the literature revealed that uncertainty is being managed in breast cancer survivors and patients with prostate cancer with watchful waiting or active surveillance. The chronic and incurable nature of indolent lymphoma, coupled with symptoms that are vague and transient, are possible sources of uncertainty in patients diagnosed with lymphoma. Nursing interventions should be aimed at assessing, educating, and supporting patients as they work toward a new view of life that incorporates uncertainty. Conclusions: Literature about the experience of patients diagnosed with lymphoma is lacking. The concept of uncertainty should be recognized by clinicians as an important aspect of living with indolent lymphoma because it is present throughout the disease trajectory and, if left untreated, can have a negative effect on patients' overall quality of life. Implications for Nursing: Uncertainty should become an ongoing component of nursing assessment in patients diagnosed with lymphoma. Further research is needed to support the application of uncertainty theory to this patient population.