Factor structure and psychometric properties of the german version chronic uncertainty scale (CU-20).

BACKGROUND: The experience of uncertainty is ubiquitous and universal across the globe. Many available tools measuring uncertainty are focused on one aspect of uncertainty, e.g., patients with life-threatening illnesses, hence a measure considering (chronic) uncertainty as an integral experience reflect ongoing uncertainties from a socio-cultural perspective is missing. Additionally, current tools do not account for an extended timeframe to measure chronic forms of uncertainty. The objective of this study is to validate a translated German version of the 20 item Chronic Uncertainty Scale (CU-20). METHODS: The full sample comprised N = 462 participants. Most of the participants were young German citizens and the sex distribution was relatively balanced (60% females; age in average: M = 24.56; SD = 4.78). Using equally split samples, an exploratory factor analysis (EFA) evaluated the CU-20 factor structure, followed by a confirmatory factor analysis (CFA) to test the established factor structure. Measurement invariance between male and female groups was evaluated. Internal consistency of the six-factor model was shown and scale discrimination was shown against chronic stress. RESULTS: The EFA results showed decent model fit for the five-factor structure, however based on the CFA results, the theoretically established six-factor model fits the data significantly better. Measurement invariance between male and female groups was shown to be clearly scalar invariant. Cronbach's alpha, omega and lambda all support internal consistency and reliability of CU-20. CONCLUSIONS: The CU-20 is a valid and reliable measure of one's state of chronic uncertainty reflecting the individuals' experiences of macrosocial forms of uncertainty, compared to the existing ones. This scale is especially useful in the context of migration, refugees or during global crises. Further psychometric testing is required in more diverse samples and a deeper look into measurement invariance is recommended.

The relative impacts of disclosure and secrecy: the role of (perceived) target response.

This review examines the current trends in understanding the impact of individuals' decisions to either disclose information or continue to conceal it. As a whole, the evidence points to a relative benefit of disclosure over secret-keeping, but with clear cases, in which disclosure may be harmful. Advances in knowledge about factors that shape that impact, new research on the role verbal rumination with a partner following disclosure, and attention to the role of communal coping as an outcome of traumatic disclosures are addressed. In addition, recent re-conceptualization of secret-keeping, and investigations into the burden experienced by confidants are reviewed. Finally, a call for greater attention to the culture-specific impacts of disclosure decisions is made.

The Functionality of Communal Coping in Chronic Uncertainty Environments: The Context of Palestinian Refugees in Lebanon.

Most research suggests that communal coping, where a group of people own and act upon a shared stressor or uncertainty together, enhances mental health and fosters coping efficacy. The majority of this research, however, has been conducted in the United States in contexts where stress and uncertainty are relatively short-lived and with samples that are economically secure and moderately to highly educated. The purpose of this study was to understand how socio-emotional conditions, such as exposure to trauma and interparental conflict, influence the functionality of communal coping for adolescents in Palestinian refugee camps in Lebanon, where chronic uncertainty is normative. One hundred eighty-five Palestinian adolescents (M age = 15.75) residing in two refugee camps in Beirut, Lebanon completed a cross-sectional survey. The results showed that communal coping with immediate family members was only beneficial for adolescents' mental health and hopelessness when their parents had moderate to little conflict and not high levels of conflict. Similarly, when adolescents had experienced trauma, engaging in high levels of communal coping accentuated, as opposed to buffered, the harmful effects of uncertainty on mental health.

Uncertainty and control in the context of a category-five tornado.

The purpose of this qualitative descriptive study was to illuminate the experience and management of uncertainty during a natural disaster. Interviews were conducted with 26 survivors of a category-five tornado that entirely demolished the small, rural town of Greensburg, Kansas. Three primary themes were found in the survivors' accounts. First, the survivors experienced rapidly shifting levels and kinds of uncertainty as they proceeded through the stages of the disaster. Second, the fluidity of much-needed information added to uncertainty. Third, the feeling of lack of control over outcomes of the disaster and its aftermath was pervasive and was often managed through reliance on communal coping. Recommendations for disaster-related intervention programs are suggested.

The relative impacts of uncertainty and mothers' communication on hopelessness among Palestinian refugee youth.

The life of adolescent refugees has been described as uncertainty laden. Yet no quantitative data exist to elucidate that experience of uncertainty, investigate its implications in that population, or explore potential moderators. This study applies the Entropy Model of Uncertainty (Hirsh, Mar, & Peterson, 2012) and the stress-buffering hypothesis (for review, see Hegelson, 2003) to examine the experience of uncertainty among adolescent Palestinians living in refugee camps in Lebanon. It then tests the role of mothers' uncertainty-related communication for adolescent hopelessness. One hundred and sixty-two adolescents across 2 refugee camps in Lebanon participated in the study. Results support the existence of elevated levels of uncertainty about both personal and macrosecurity, show an association between uncertainty regarding personal security and levels of hopelessness, and suggest that uncertainty's negative impact may overwhelm the role of mothers' supportive communication as a buffer against hopelessness. Interestingly, the data also suggest surprisingly little hopelessness in this population.

The impact of uncertainty and communal coping on mental health following natural disasters.

Feelings of uncertainty are a central feature of the disaster experience. Surprisingly, though, there is very little systematic quantitative research about the impact of uncertainty on disaster survivors. Moreover, communal coping has increasingly received attention as a potential buffer of the negative effects of stressors but that literature is also limited in its application to disasters. This investigation applies research in the domain of uncertainty, together with the Theoretical Model of Communal Coping to better understand the experience of a community exposed to three wildfires in a one year period. A random-digit dialing procedure was used to gather data from 402 individuals. Participants completed measures of mental health, uncertainty, and communal coping in the context of their experience with the most personally stressful of the three wildfires. All analyses were examined separately for those who were evacuated and those who were not. Results support the negative impact of uncertainty across both evacuated and nonevacuated sub-samples and show a strong buffering role for communal coping among those who evacuated. The implications of these findings for the understanding of wildfire survivors' experiences are noted and future directions are proposed.

When families talk: applying interpretative phenomenological analysis to African American families discussing their awareness, commitment, and knowledge of organ donation.

This paper applies interpretative phenomenological analysis as a tool to understand ways African American families discuss and make sense of their knowledge, awareness, and commitment of the organ donation process. African American families (n = 20) participated in self-directed conversations based on the organ donor model, which is grounded in the theory of reasoned action and the theory of motivated information management. Results indicate that the media strongly influences an individual's willingness to participate in the organ donation process and their commitment to further discuss their decisions with close family members. Greater attention should be given to cultural-specific campaigns to increase the number of African American donors.

Religiosity, anxiety, and discussions about organ donation: understanding a complex system of associations.

An increasingly large research base on religiosity has shown it to have a buffering effect on anxiety. In a separate vein, scholars interested in organ donation have suggested that both religiosity and anxiety play roles in individuals' willingness to seek information concerning their decisions about organ donations with their family-an event that greatly increases donation rates. This investigation presents 2 studies that examine the associations between religiosity and anxiety (variously measured), on the one hand, and anxiety and individual's information seeking behaviors with family members about organ donation on the other. The first study offers national samples and relies on self-reports, whereas the second study is one of the few organ donation studies to provide observer ratings of interaction between family members on the issue. Results suggest a more complicated role of religiosity with regard to anxiety than previously believed and show a consistent and robust association between anxiety and communication behaviors regarding organ donation. Implications for campaigns are discussed.

Facts versus 'Feelings': how rational is the decision to become an organ donor?

Researchers are already aware that decision making about health issues is not necessarily driven by rational or cognitive-based decision-making processes. This appears to be especially true for the decision to donate organs. Although hints about what is actually driving the decision-making process are scattered throughout the literature, noncognitive factors have not been tested systematically. Structural equation modeling of data gathered from 4426 participants at six different geographic locations in the United States demonstrates that cognitive-based factors (such as knowledge about donation) are less influential on the decision to donate than noncognitive variables such as the desire to maintain bodily integrity, worries that signing a donor card might 'jinx' a person, and medical mistrust.

In their own words: the reasons why people will (not) sign an organ donor card.

This multisite, qualitative study of 78 family-pair dyads provides rich data on the reasons people cite for (not) wanting to sign an organ donor card in the context of family conversations. In this study, dyads were videotaped as they discussed 8 questions pertaining to their views on organ donation, beginning with the most general opinions and progressing to more detailed questions. Analysis of the transcribed data revealed that the most common reasons for wanting to donate organs were based on religion or a desire to help other people in need. The most common reasons cited for not wanting to donate organs were mistrust (of doctors, hospitals, and the organ allocation system), a belief in a black market for organs in the United States, and deservingness issues (that one's organs would go to someone who brought on his or her own illness, or who could be a "bad person"). One of the most surprising findings is that religion is offered far more often as a rationale for wanting to help sick people through organ donation than it was for not wanting to donate organs. These findings both support and contradict past studies based on quantitative survey data. Implications for the construction of more effective future organ donor campaigns are discussed.

Family discussions about organ donation: how the media influences opinions about donation decisions.

In this study, 78 family pair dyads (spouses, parent-child pairs, or siblings) were brought into an interaction laboratory set up like a living room. After being briefed on the study, family members discussed a series of eight questions about their thoughts and opinions about organ donation. Thematic analysis of the thousands of pages of transcripts revealed that family members believe that they receive important information about organ donation through the media. Unfortunately, the most influential information came from sensationalistic, negative media portrayals. The myths that seem to be the most actively referenced by the media include premature declaration of death, the transference of personality traits from donor to recipient, a US black market for organs, corruption in the medical community, and corruption in the organ allocation system (which allows celebrities to get transplants first). Although these are not the only myths that the generally public holds to be true, the media is a powerful source of support for these particular myths. Therefore, such myths must be countered effectively if greater consent for organ donation is to be attained.