Mishel's Theory of Uncertainty in Illness (1988) is a mid-level nursing theory that examines how uncertainty can affect patients. Furthermore, Mishel's theory identifies the causes of uncertainty that negatively or positively influence the patient. If an individual is following a known disease path, he or she may perceive uncertainty as an advantage. However, the uncertainty of illness causes breakdowns, fear of illness, emotional distress, loss of control, and inappropriate coping methods (Mishel 1988). These conditions, if left untreated, will lead patients to be unable to form cognitive structures for disease-related events, develop improper psychological adaptations, make poor decisions, and experience traumatic responses to stress (Mishel 1988). Along with his theory, Mishel (1988) developed an uncertainty rating scale to measure an individual's degree of uncertainty during acute injuries, illnesses, and chronic disease recurrences. There is a desire to know what is happening to one's body and not understanding the disease will lead patients to feel less comfortable. It is the nursing profession's obligation to help patients understand what illness means to them, expect outcomes, and manage the stress that comes with uncertainty. Mishel's (1981) theory is an important aspect of the nurse's ability to overcome obstacles posed by uncertainty for the benefit of patients' well-being. Uncertainty in Chronic Illness Chronic illness puts people in a state of alert awareness of their condition. Although chronic conditions and their outcomes are well studied, the psychological effects of uncertainty remain under question (Baily, Lawrence, Barroso, Bixby, Michel, Muir, Strickland & Clip, 2009). The intrusion of any chronic disease is a highly stressful… middle of paper… factor that invokes greater perceived severity of symptoms (Johson, Zautra & Davis, 2006). Nurses entering the field of practice must be prepared to encounter and manage varying levels and symptoms of uncertainty. Managing uncertainty as nurses Levels of uncertainty can lead to increased symptoms and many negative psychological effects (Mishel 1988). Nurses entering the field of practice must understand the effects of uncertainty and adapt efforts to help patients with this added stressor. It is the nursing profession's job to learn how to create interventions to help patients deal with uncertainty. Using up-to-date research, effectively informing individuals about findings, and teaching self-management techniques is critical to reducing levels of uncertainty in individuals with chronic illnesses (McNulty, K., Lineh, H., & Wilson, L. 2004).