• Yingzi Zhang, Kristine Kwekkeboom, and Marcia Petrini.
• Author Affiliations: School of Nursing, Wuhan University, Wuhan, Hubei, China (Ms Zhang and Dr Petrini); and School of Nursing, University of Wisconsin-Madison (Ms Zhang and Dr Kwekkeboom).
• Cancer Nurs. 2015 May 1; 38 (3): E19-26.

BackgroundTreatment for breast cancer causes uncertainty in the face of new and distressing experiences and often results in the need for self-care. Identifying how uncertainty influences self-care behavior is essential to design interventions that enhance self-care capacity and improve patient outcomes.ObjectivesThe aims of this study were to describe the levels of uncertainty, self-efficacy, and self-care behavior in Chinese women receiving chemotherapy for breast cancer and to determine if self-efficacy mediates the relationship between uncertainty and self-care behavior.MethodsA cross-sectional descriptive correlational design was used. Ninety-seven participants completed the Generalized Self-efficacy Scale, the Mishel Uncertainty in Illness Scale, and the Appraisal of Self-care Agency Scale-Revised. Descriptive statistics were used to analyze the levels of uncertainty, self-efficacy, and self-care behaviors in the sample. Multiple regression was used to test the mediating effect of self-efficacy in the relationship between uncertainty and self-care behavior.ResultsMean ratings of uncertainty (76.70), self-efficacy (27.15), and self-care behavior (53.96) all fell in the moderate range. Both uncertainty and self-efficacy independently predicted self-care behavior, explaining 18.2% of the variance, but self-efficacy did not mediate the relationship between uncertainty and self-care behavior.ConclusionsResearch is needed to further evaluate the proposed relationships using instruments specific to/related to cancer and evaluate change over time. Self-care interventions that have been efficacious in Western populations could be revised to assist Chinese women to reduce uncertainty and enhance self-efficacy in coping with breast cancer.Implications For PracticeSelf-care intervention programs should include strategies to reduce uncertainty and enhance self-efficacy in coping with breast cancer treatment.

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