BACKGROUND: Management of the uncertainty inherent in a diagnosis of a
progressive neurological illness is one of the major adjustment tasks facing those
affected and their families. A causal relationship has been demonstrated between perceived
illness uncertainty and negative psychological outcomes for individuals with progressive
neurological illness. Whilst there is a small and promising intervention literature on the
use of a range of individually focused strengths based psychological interventions there
appears to be little guidance available how clinicians might help those family members of
those affected.
OBJECTIVE: To undertake a systematic review of the evidence on the use of
strengths based, family focused interventions that target illness uncertainty.
METHODS: A systematic literature search was undertaken using the National
Library for Health abstract database.
RESULTS: Five papers were included in the review, only two of which were
published in peer reviewed journals. All five reported on strengths based approaches that
could be used with families but only two explicitly identified illness uncertainty as a
target. Outcome measures were heterogeneous so data could not be aggregated for
meta-analysis. The results suggested that these interventions showed promised but the
review highlighted a number of methodological issues which mean that the results must be
interpreted with caution.
CONCLUSIONS: There is very little evidence of the use of strengths based
approaches to helping families manage the uncertainty associated with progressive
neurological illness despite it having been identified as a key target for intervention.
The review highlights the need for the development of an intervention framework to address
this key clinical issue and suggests one model that might show promise.
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