The impact of illness uncertainty on self-efficacy, personal control, and negative emotions in elderly persons with colon cancer

BACKGROUND: Colon cancer is a significant health concern among the elderly, compounded by the psychological burden of illness uncertainty. This uncertainty can adversely affect self-efficacy, personal control, and emotional well-being. Despite its significance, the influence of illness uncertainty on elderly persons with colon cancer has been inadequately explored. METHODS: This retrospective cohort study analyzes 286 elderly persons with colon cancer treated between October 2021 and October 2023. Patients were categorized into high and low uncertainty groups based on scores from the Mishel Illness uncertainty Scale. We evaluated self-efficacy using the Strategies Used by People to Promote Health scale, personal control via the Personal Mastery Scale, and negative emotions using the Self-Perceived Burden Scale for Cancer Patients. In addition, a multivariate logistic regression analysis was performed to explore the factors related to disease uncertainty. RESULTS: Patients in the high uncertainty group (n = 172) demonstrated significantly lower self-efficacy, characterized by diminished stress reduction and positive attitude (P < 0.01). This group also exhibited reduced personal control (P = 0.002) and heightened negative emotional states, such as anxiety (P = 0.008). High uncertainty was associated with increased perceived burdens, including economic and treatment-related burdens (P < 0.05). Multivariate logistic regression analysis revealed that educational level, self-rated economic burden caused by the disease, self-stress reduction, positive attitude, total score of self-efficacy, and treatment burden were significantly associated with disease uncertainty. CONCLUSION: Illness uncertainty profoundly impacts the psychosocial well-being of elderly persons with colon cancer, decreasing self-efficacy and personal control while increasing negative emotions and perceived burdens.