The article “Illness Uncertainty and Posttraumatic Stress in Young Adults with Congenital Heart Disease” by Moreland and Santacroce (2018), reports on the effects of illness uncertainty in a sample of young adults who were diagnosed with congenital heart disease as children. In order to be included in this study, Moreland and Santacroce required participants to be between the ages of 19 and 35, be literate in English, and to have been diagnosed with congenital heart disease as a child. Exclusion criteria was significant cognitive impairment.
The purpose of Moreland and Santacroce’s 2018 study was to explore correlations between posttraumatic stress syndrome and the appraisal and management process in the aforementioned population. It was also to help determine how these young adults experience uncertainty (Moreland & Santacroce, 2018).
Moreland and Santacroce (2018) do not mention whether similar studies have been done in this population in the past. However, they do cite past research done in different populations with chronic illness. These studies were useful in supporting the findings of this research, nonetheless, a more thorough literature review would have been helpful. Moreland and Santacroce used Mishel’s Uncertainty in Illness Theory as a conceptual framework for the study. This theory describes four domains including ambiguity, lack of information, complexity of the healthcare system, and unpredictability of illness (Moreland & Santacroce, 2018).
Ethical considerations were upheld by Moreland and Santacroce. They obtained consent from all participants and approval from the institution’s IRB board. Participants’ privacy was protected by replacing their names with an identification number (Moreland & Santacroce, 2018).
An exploratory descriptive design was used for this primarily qualitative study. According to Polit et al. (2018), this is a type of mixed method design in which qualitative data is typically collected first, then quantitative data subsequently. Polit et al. state that qualitative data may have more of an emphasis over quantitative data in these types of studies, or vice versa. This type of design was fitting for the aims of the study, as it allowed the researchers to use both information-rich interviews and some quantitative data on post-traumatic stress disorder screening tools to help explore the phenomena.
Moreland and Santacroce (2018) recruited participants using social media forums and fliers posted in public places. Participants were then chosen using purposive sampling. Purposive sampling was a good method to use in this case because it allowed the researchers to choose participants who would be most valuable to the study, in contrast to a randomized method. Because this was a qualitative study, the sample size of 25 participants was appropriate (Polit et al. 2018).
However, Moreland and Santacroce (2018) do not state that data was collected to the point of saturation, which is a key element in determining whether more participants are needed (Moreland & Santacroce, 2018, Polit et al. 2018). Data was collected using interviews, which were conducted either in person or by skype (Moreland & Santacroce, 2018). Data collected included information on the participant’s age, gender, race, employment status, and other sociodemographic variables. The interviewers also asked open-ended questions to encourage the participants to tell the story of their childhood illness and how it is affecting their life.
Because Moreland and Santacroce (2018) chose a mixed-methods design for their study, both qualitative and quantitative data were collected. Descriptive statistics were used to analyze the quantitative data, while constant comparison was used for the qualitative aspects. The interviews were thoroughly examined for the four key domains. Once these were identified, interviews were compared to categories of a PTSD scale and rated as to how many of these categories were met. The data was ranked as mild, moderate or severe post-traumatic stress syndrome.
Finally, central themes were identified. In the sample studied, uncertainty was found to be a common theme, and was also found to affect the participants’ daily lives (Moreland & Santacroce, 2018).
Subjects were discovered to be at higher risk for psychological distress, and methods used to manage uncertainty were found to affect their risk for post-traumatic stress syndrome. This study showed the importance of evaluating patients who have had congenital heart disease as children for post-traumatic stress disorder, and of taking steps to decrease uncertainty in this population from childhood (Moreland & Santacroce, 2018).
