Restricted accessResearch articleFirst published online 2021-6
The Relationship Between Anxiety and Intolerance of Uncertainty Levels in Individuals Who Received Liver Transplant: A Descriptive Cross-Sectional Study
Studies have revealed that anxiety is associated with intolerance of uncertainty (IU); however, no study has examined the predictive effect of IU on anxiety in individuals with liver transplantation (LT). Therefore, this study aimed to identify the relationship between anxiety and IU levels in individuals who received LT. A descriptive cross-sectional study with a convenience sample (N = 118) was conducted at a center in eastern Turkey. The data were analyzed using descriptive statistics, correlation, and hierarchical linear regression analysis. The mean scores for the dimensions of IU, state anxiety and trait anxiety were 34.42 ± 8.35, 40.38 ± 10.07, and 41.88 ± 7.53, respectively. IU and anxiety in individuals with LT were identified as related dynamics. Present findings suggest that uncertainty and IU can be considered in the conceptualization and treatment of anxiety and related pathologies. Nurses may seriously consider these results in order to increase the quality of the treatment and care provided to patients.
AnnemaC.RoodbolP. F.StewartR. E.PorteR. J.RanchorA. V. (2015). Prevalence of psychological problems and associated transplant-related variables at different time periods after liver transplantation. Liver Transplantation, 21(4), 524–538. https://doi.org/10.1002/lt.24075.
2.
BaghernezhadM.ManiA.AyoobzadehshiraziA.RoozbehJ.ZareM.NikeghbalianS.Malek-HosseiniS. A.GholamS.Bazargan-HejaziS. (2018). Psychologic evaluation in liver transplantation: assessment of psychologic profile of end-stage liver disease patients before and after transplant. Experimental and Clinical Transplantation : Official Journal of the Middle East Society for Organ Transplantation, 18(3), 339–344. https://doi.org/10.6002/ect.2017.0135.
3.
BoelenP. A.ReijntjesA.CarletonR. N. (2014). Intolerance of uncertainty and adult separation anxiety. Cognitive Behaviour Therapy, 43(2), 133–144. https://doi.org/10.1080/16506073.2014.888755.
4.
BredemeierK.BerenbaumH. (2008). Intolerance of uncertainty and perceived threat. Behaviour Research and Therapy, 46(1), 28–38. https://doi.org/10.1016/j.brat.2007.09.006.
5.
BuhrK.DugasM. J. (2002). The intolerance of uncertainty scale: psychometric properties of the English version. Behaviour Research and Therapy, 40(8), 931–945. https://doi.org/10.1016/S0005-7967(01)00092-4.
CarletonR. N. (2016b). Into the unknown: A review and synthesis of contemporary models involving uncertainty. Journal of Anxiety Disorders, 39, 30–43. https://doi.org/10.1016/j.janxdis.2016.02.007.
8.
CarletonR. N.MulvogueM. K.ThibodeauM. A.McCabeR. E.AntonyM. M.AsmundsonG. J. G. (2012). Increasingly certain about uncertainty: Intolerance of uncertainty across anxiety and depression. Journal of Anxiety Disorders, 26(3), 468–479. https://doi.org/10.1016/j.janxdis.2012.01.011.
9.
ChenP.-X.YanL.-N.WangW.-T. (2012). Health-related quality of life of 256 recipients after liver transplantation. World Journal of Gastroenterology: WJG, 18(36), 5114.
10.
ChenS.YaoN.QianM. (2018). The influence of uncertainty and intolerance of uncertainty on anxiety. Journal of Behavior Therapy and Experimental Psychiatry, 61, 60–65. https://doi.org/10.1016/j.jbtep.2018.06.005.
11.
CohenJ. (1988). Statistical power analysis for the behavioral sciences. Routledge.
12.
CorbettC.ArmstrongM. J.ParkerR.WebbK.NeubergerJ. M. (2013). Mental health disorders and solid-organ transplant recipients. Transplantation, 96(7), 593–600. https://doi.org/10.1097/TP.0b013e31829584e0
13.
CraigJ. A.MinerD.RemtullaT.MillerJ.ZanussiL. W. (2017). Piloting a coping skills group intervention to reduce depression and anxiety symptoms in patients awaiting kidney or liver transplant. Health & Social Work, 42(1), e44–e52. https://doi.org/10.1093/hsw/hlw064
14.
CruzD. d. A. L. M. d.PimentaC. A. d. M. (2005). Prática baseada em evidências, aplicada ao raciocínio diagnóstico. Revista Latino-Americana de Enfermagem, 13, 415–422.
15.
DarW. A.SullivanE.BynonJ. S.EltzschigH.JuC. (2019). Ischaemia reperfusion injury in liver transplantation: Cellular and molecular mechanisms. Liver International, 39(5), 788–801. https://doi.org/10.1111/liv.14091.
16.
DugasM. J.HedayatiM.KaravidasA.BuhrK.FrancisK.PhillipsN. A. (2005). Intolerance of uncertainty and information processing: Evidence of biased recall and interpretations. Cognitive Therapy and Research, 29(1), 57–70. https://doi.org/10.1007/s10608-005-1648-9
17.
DugasM. J.SchwartzA.FrancisK. (2004). Brief report: Intolerance of uncertainty, worry, and depression. Cognitive Therapy and Research, 28(6), 835–842. https://doi.org/10.1007/s10608-004-0669-0
18.
FaulF.ErdfelderE.BuchnerA.LangA.-G. (2009). Statistical power analyses using G*Power 3.1: Tests for correlation and regression analyses. Behavior Research Methods, 41(4), 1149–1160. https://doi.org/10.3758/brm.41.4.1149
19.
FukunishiI.SugawaraY.TakayamaT.MakuuchiM.KawarasakiH.SurmanO. S. (2001). Psychiatric disorders before and after living-related transplantation. Psychosomatics, 42(4), 337–343. https://doi.org/10.1176/appi.psy.42.4.337
20.
FukunishiI.SugawaraY.TakayamaT.MakuuchiM.KawarasakiH.SurmanO. S. (2002). Association between pretransplant psychological assessments and posttransplant psychiatric disorders in living-related transplantation. Psychosomatics, 43(1), 49–54. https://doi.org/10.1176/appi.psy.43.1.49
21.
GentesE. L.RuscioA. M. (2011). A meta-analysis of the relation of intolerance of uncertainty to symptoms of generalized anxiety disorder, major depressive disorder, and obsessive–compulsive disorder. Clinical Psychology Review, 31(6), 923–933. https://doi.org/10.1016/j.cpr.2011.05.001
22.
GroverS.SarkarS. (2012). Liver transplant psychiatric and psychosocial aspects. Journal of Clinical and Experimental Hepatology, 2(4), 382–392. https://doi.org/10.1016/j.jceh.2012.08.003
23.
HeoJ.NohO. K.OhY.-T.ChunM.KimL. (2018). Psychiatric comorbidities among patients undergoing liver transplantation in South Korea: A nationwide population-based study. Hepatology International, 12(2), 174–180. https://doi.org/10.1007/s12072-018-9849-y
24.
HerdmanT. H.KamitsuruS. (2018). NANDA International, Inc. nursing diagnoses : Definitions and classification 2018-2020 (Eleventh Edition ed.): Thieme.
25.
HezelD. M.StewartS. E.RiemannB. C.McNallyR. J. (2019). Standard of proof and intolerance of uncertainty in obsessive-compulsive disorder and social anxiety disorder. Journal of Behavior Therapy and Experimental Psychiatry, 64, 36–44. https://doi.org/10.1016/j.jbtep.2019.02.002
26.
HongR. Y. (2007). Worry and rumination: Differential associations with anxious and depressive symptoms and coping behavior. Behaviour Research and Therapy, 45(2), 277–290. https://doi.org/10.1016/j.brat.2006.03.006
27.
HongR. Y.CheungM. W.-L. (2015). The structure of cognitive vulnerabilities to depression and anxiety: Evidence for a common core etiologic process based on a meta-analytic review. Clinical Psychological Science, 3(6), 892–912. https://doi.org/10.1177/2167702614553789
28.
KanayamaG.HudsonJ. I.PopeH. G. (2008). Long-term psychiatric and medical consequences of anabolic–androgenic steroid abuse: A looming public health concern?Drug and Alcohol Dependence, 98(1), 1–12. https://doi.org/10.1016/j.drugalcdep.2008.05.004
29.
MatteiG.MoscaraM.BalducciJ.CavanaS.CherubiniM.PiemonteC.FerrariS.GaleazziG. M. (2019). Stability of psychiatric diagnoses in candidates to liver transplantation referred to a consultation-liaison psychiatry service. Journal of Clinical Medicine, 8(6), 800.
30.
McEvoyP. M.MahoneyA. E. J. (2012). To be sure, to be sure: Intolerance of uncertainty mediates symptoms of various anxiety disorders and depression. Behavior Therapy, 43(3), 533–545. https://doi.org/10.1016/j.beth.2011.02.007
31.
MendesK. D. S.LopesA. R. F.MartinsT. A.LopesG. F.ZivianiL. C.RossinF. M.Castro-e-SilvabO.GalvãoC. M. (2014). Relevance of anxiety and stress levels on sleep quality after liver transplantation. Transplantation Proceedings, 46(6), 1822–1826. https://doi.org/10.1016/j.transproceed.2014.05.051
32.
MilneS.LomaxC.FreestonM. H. (2019). A review of the relationship between intolerance of uncertainty and threat appraisal in anxiety. The Cognitive Behaviour Therapist, 12, e38. https://doi.org/10.1017/S1754470X19000230
33.
OglesbyM. E.SchmidtN. B. (2017). The role of threat level and intolerance of uncertainty (IU) in anxiety: An experimental test of IU theory. Behavior Therapy, 48(4), 427–434. https://doi.org/10.1016/j.beth.2017.01.005
34.
OliveiraN.ChiancaT.RassoolG. H. (2008). A validation study of the nursing diagnosis anxiety in Brazil. International Journal of Nursing Terminologies and Classifications, 19(3), 102–110. https://doi.org/10.1111/j.1744-618X.2008.00089.x
35.
ÖnerN.LeCompteW. A. (1985). Durumluk-sürekli kaygı envanteri el kitabı: Boğaziçi Üniversitesi Yayınları.
36.
PelgurH.AtakN.KoseK. (2009). Anxiety and depression levels of patients undergoing liver transplantation and their need for training. Transplantation Proceedings, 41(5), 1743–1748. https://doi.org/10.1016/j.transproceed.2008.11.012
ReumanL.JacobyR. J.FabricantL. E.HerringB.AbramowitzJ. S. (2015). Uncertainty as an anxiety cue at high and low levels of threat. Journal of Behavior Therapy and Experimental Psychiatry, 47, 111–119. https://doi.org/10.1016/j.jbtep.2014.12.002
39.
RodrigueJ. R.HantoD. W.CurryM. P. (2011). Patients’ expectations and success criteria for liver transplantation. Liver Transplantation, 17(11), 1309–1317. https://doi.org/10.1002/lt.22355
40.
RosenN. O.KnäuperB. (2009). A little uncertainty goes a long way: State and trait differences in uncertainty interact to increase information seeking but also increase worry. Health Communication, 24(3), 228–238. https://doi.org/10.1080/10410230902804125
41.
RussellR. T.FeurerI. D.WisawatapnimitP.SalomonR. M.PinsonC. W. (2008). The effects of physical quality of life, time, and gender on change in symptoms of anxiety and depression after liver transplantation. Journal of Gastrointestinal Surgery, 12(1), 138–144. https://doi.org/10.1007/s11605-007-0382-x
42.
SansonG.PerroneA.FascìA.D’AgostinoF. (2018). Prevalence, defining characteristics, and related factors of the nursing diagnosis of anxiety in hospitalized medical-surgical patients. Journal of Nursing Scholarship, 50(2), 181–190. https://doi.org/10.1111/jnu.12370
43.
SarıçamH.ErguvanF. M.AkınA.AkçaM. Ş. (2014). The Turkish short version of the intolerance of uncertainty (Ius-12) scale: The study of validity and reliability. Route Education and Social Science Journal, 1(3), 148–157.
44.
SpielbergerC. D. (1983). State-trait anxiety inventory for adults.
45.
SurianoM. L. F.MichelJ. M.ZeitounS. S.HerdmanT. H.de BarrosA. L. B. L. (2011). Consensual validation of the nursing diagnoses fear and anxiety identified at the immediate preoperative period in patients undergoing elective surgery. International Journal of Nursing Terminologies and Classifications, 22(3), 133–141. https://doi.org/10.1111/j.1744-618X.2011.01181.x
46.
TanovicE.GeeD. G.JoormannJ. (2018). Intolerance of uncertainty: Neural and psychophysiological correlates of the perception of uncertainty as threatening. Clinical Psychology Review, 60, 87–99. https://doi.org/10.1016/j.cpr.2018.01.001
ÜnayM.ÖnderA.Gizli ÇobanÖ.AtalayA.Sürer AdanirA.ArtanR.ÖzatalayE. (2019). Psychopathology, quality of life, and related factors in pediatric liver transplantation candidates and recipients. Pediatric Transplantation, 24(1), e13633. https://doi.org/10.1111/petr.13633
49.
YıldızE.KılınçG. (2018). The relationship between anxiety-depression status and psychosocial adjustments in the patients undergoing liver transplantation. Perspectives in Psychiatric Care, 54(2), 221–229. https://doi.org/10.1111/ppc.12226
50.
YoungL. K.PolzinJ.ToddS.SimuncakS. L. (2002). Validation of the nursing diagnosis anxiety in adult patients undergoing bone marrow transplant. International Journal of Nursing Terminologies and Classifications, 13(3), 88–100. https://doi.org/10.1111/j.1744-618X.2002.tb00408.x
Supplementary Material
Please find the following supplemental material available below.
For Open Access articles published under a Creative Commons License, all supplemental material carries the same license as the article it is associated with.
For non-Open Access articles published, all supplemental material carries a non-exclusive license, and permission requests for re-use of supplemental material or any part of supplemental material shall be sent directly to the copyright owner as specified in the copyright notice associated with the article.
