Mapping illness uncertainty in adolescents with cancer: A cross-sectional network analysis.
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PURPOSE: Illness uncertainty, as conceptualised in Mishel's theory, is an important psychosocial issue in paediatric oncology. This study aimed to describe illness uncertainty from adolescents' perspective, examine its item-level network structure and identify central concerns and key co-occurring pathways. METHODS: Illness uncertainty was assessed using the Chinese version of the Uncertainty Scale for Kids, which includes the unpredictability (UP), complexity (CP) and uncertainty (UC) dimensions, with a total score ranging from 0 to 80. An item-level partial correlation network was estimated, and the node strength centrality and edge weights were examined. RESULTS: The mean total illness uncertainty score was 42.94 ± 11.46, indicating a moderate level of illness uncertainty. Items UC11 (expected illness course; strength = 1.292), UP15 (changes in condition; strength = 1.068), UP4 (illness outcome; strength = 1.039) demonstrated the highest strength centrality. The strongest edges formed four co-occurring pathways: disease trajectory judgment, including UP3-UP4 (weight = 0.324), UC9-UP20 (weight = 0.279), UP3-UP5 (weight = 0.249) and UP15-UC16 (weight = 0.242); symptom attribution, represented by CP18-UC19 (weight = 0.354); treatment-related risk, including UC12-CP14 (weight = 0.389) and CP8-UP13 (weight = 0.258); and information interpretation, represented by CP7-UC11 (weight = 0.251). CONCLUSION: The findings underscore the importance of assessing illness uncertainty from the perspective of adolescent patients. Given the cross-sectional design, use of convenience sampling and absence of subgroup network analyses in this study, future longitudinal and multicentre studies are recommended to validate the above findings.