Uncertainty and self-efficacy in parents of a child with congenital cataract-New implications for clinical practice

Abstract

Aim: The aim was an in-depth exploration of uncertainty and self-efficacy among parents of a child with congenital cataract by means of two theoretical frameworks to re-design family care.

Design: A directed content analysis in accordance with Hsieh & Shannon, using Mishel's theory of uncertainty and Bandura's self-efficacy theory.

Methods: Open-ended, in-depth interviews were conducted with 23 parents of a child with congenital cataract; six mothers, five fathers and six couples.

Results: In this novel study, self-efficacy was interpreted as the ability to balance between uncertainty and acceptance. The performance accomplishment of the child and parents bridges the gap between uncertainty and acceptance by reducing uncertainty, thus constituting the level of self-efficacy. Setbacks and complications increase uncertainty and reduce self-efficacy, thus performance accomplishment is a mediator of self-efficacy, while ability to master uncertainty determines the level of self-efficacy.

Keywords: congenital cataract; content analysis; nursing; parental perspective; qualitative; self‐efficacy; self‐management; uncertainty.

Figure 1

As visualized in figure, parental uncertainty involves many different aspects illustrated by several crucial questions: Where does the cataract stem from? Did I cause the cataract? (Causes) Is the occlusion therapy working? (Treatment) What will happen to my child? What is the plan for my child? (Follow‐up) Will my child be visually impaired or even blind for the rest of her/his life? (Prognosis) Will my child be able to drive a car, work and move out as an adult? (Future) Am I doing the right thing and am I doing enough as a parent? (Parental performance)

Figure 2

As visualized in figure, parental acceptance involves many different aspects illustrated by several areas in life