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Prognostic uncertainty in multiple sclerosis: A concept analysis.

Kelly Jean Dickerson1,2

  • 1University of Missouri - Kansas City, Kansas City, MO, USA.

Journal of Clinical Nursing
|October 13, 2021
PubMed
Summary

Prognostic uncertainty in multiple sclerosis (MS) is poorly understood, impacting patient-physician communication. Genetics and genomics may offer future prognostic factors for MS patients.

Keywords:
concept analysismultiple sclerosisprognostic uncertaintyprogression

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Area of Science:

  • Neurology
  • Genetics
  • Nursing

Background:

  • Multiple sclerosis (MS) diagnosis complexity causes prognostic uncertainty.
  • Patients experience uncertainty transitioning between relapsing-remitting MS and secondary progressive MS.

Purpose of the Study:

  • To perform a concept analysis of prognostic uncertainty in multiple sclerosis patients.
  • To define the attributes and implications of prognostic uncertainty in MS.

Main Methods:

  • Concept analysis using the Walker and Avant method.
  • Literature search of PubMed, Ovid Medline, and CINAHL within the last 10 years.
  • Keywords: prognostic uncertainty, diagnostic uncertainty, multiple sclerosis.

Main Results:

  • Defining attributes of prognostic uncertainty include illness uncertainty, intolerance of uncertainty, and progressive dwindling.
  • Analysis includes related, contrary, model, and borderline cases to illustrate the concept.
  • Limited data exist, but patients and physicians report uncertainty regarding disease trajectory and transitions.

Conclusions:

  • Prognostic uncertainty in MS hinders effective communication and causes frustration.
  • Genetics and genomics show potential for providing prognostic factors in MS.
  • Nurses should be involved in genetic/genomic research to translate findings into clinical practice for chronic illness management.