{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,8]],"date-time":"2026-10-08T15:10:41Z","timestamp":1791472241111,"version":"4.3.4"},"reference-count":42,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2022,2,20]],"date-time":"2022-02-20T00:00:00Z","timestamp":1645315200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100006093","name":"Patient-Centered Outcomes Research Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006093","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Psycho-Oncology"],"published-print":{"date-parts":[[2022,6]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>One primary source of psychological distress in patients with cancer and their caregivers is uncertainty. However, the uncertainty trajectory and its relationship between older adults with advanced cancer and their caregivers have rarely been examined. This study describes the uncertainty trajectory in patient\u2010caregiver dyads, explores the effect of geriatric assessment (GA) intervention on trajectory, and examines the interdependent relationship of uncertainty.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This secondary analysis used longitudinal data from a national cluster\u2010randomized controlled trial examining a GA intervention compared to usual care. Participants completed the modified 9\u2010item Mishel Uncertainty in Illness Scale at enrollment, 4\u20136\u00a0weeks, 3\u00a0months, and 6\u00a0months. The dyadic growth model and cross\u2010lagged actor\u2010partner interdependence model were used.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 397\u00a0dyads (patient age <jats:italic>M<\/jats:italic>\u00a0=\u00a076.81\u00a0\u00b1\u00a0SD5.43; caregiver age <jats:italic>M<\/jats:italic>\u00a0=\u00a066.69\u00a0\u00b1\u00a0SD12.52) were included. Both had a trend of decreased uncertainty over time (<jats:italic>b<\/jats:italic>\u00a0=\u00a0\u22120.16, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). There was a greater decrease in uncertainty among caregivers in the GA group than those in the usual care group (<jats:italic>b<\/jats:italic>\u00a0=\u00a0\u22120.46, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.02). For both patients and caregivers, their past uncertainty was a significant predictor of their own current uncertainty (i.e., actor effect, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.01). The individual's past uncertainty was a significant predictor of the other dyad member's current uncertainty (i.e., partner effect, <jats:italic>p<\/jats:italic>\u00a0&lt;\u00a00.05), indicating an interdependent relationship between patient and caregiver uncertainty over time.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Findings suggest patient and caregiver function as a unit with uncertainty levels affecting each other. Future interventions could build on GA to address uncertainty for older patients with advanced cancer and caregivers.<\/jats:p><\/jats:sec>","DOI":"10.1002\/pon.5895","type":"journal-article","created":{"date-parts":[[2022,2,3]],"date-time":"2022-02-03T09:48:57Z","timestamp":1643881737000},"page":"1041-1049","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":19,"title":["The shared uncertainty experience of older adults with advanced cancer and their caregivers"],"prefix":"10.1002","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3596-7126","authenticated-orcid":false,"given":"Yingzi","family":"Zhang","sequence":"first","affiliation":[{"name":"School of Nursing, University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Supriya","family":"Mohile","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eva","family":"Culakova","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sally","family":"Norton","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6978-0418","authenticated-orcid":false,"given":"Kah Poh","family":"Loh","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sindhuja","family":"Kadambi","sequence":"additional","affiliation":[{"name":"Division of Hematology\/Oncology, Department of Medicine, Wilmot Cancer Institute, University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lee","family":"Kehoe","sequence":"additional","affiliation":[{"name":"Department of Surgery, Cancer Control, University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7648-7113","authenticated-orcid":false,"given":"Valerie","family":"Aarne Grossman","sequence":"additional","affiliation":[{"name":"SCOREboard Patient and Caregiver Advocacy Group, University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Victor G.","family":"Vogel","sequence":"additional","affiliation":[{"name":"Geisinger Cancer Institute NCORP  Danville Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian L.","family":"Burnette","sequence":"additional","affiliation":[{"name":"Cancer Research of Wisconsin and Northern Michigan  Green Bay Wisconsin USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thomas P.","family":"Bradley","sequence":"additional","affiliation":[{"name":"Northwell Health NCORP  New Hyde Park New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marie","family":"Flannery","sequence":"additional","affiliation":[{"name":"School of Nursing, University of Rochester Medical Center  Rochester New York USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,2,20]]},"reference":[{"key":"e_1_2_11_2_1","doi-asserted-by":"publisher","DOI":"10.3322\/caac.21654"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41571\u2010020\u20100421\u2010z"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2019.09.005"},{"key":"e_1_2_11_5_1","doi-asserted-by":"publisher","DOI":"10.1007\/978\u20103\u2010319\u201057348\u20109_27"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1089\/jpm.2013.0625"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1188\/17.ONF.E152\u2010E167"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1200\/JCO.2008.19.9463"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jgo.2016.12.001"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010019\u201004711\u20106"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/jgs.15862"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1547\u20105069.1988.tb00082.x"},{"key":"e_1_2_11_13_1","doi-asserted-by":"publisher","DOI":"10.1590\/1518\u20108345.3185.3200"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1365\u20102702.2008.02549.x"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpainsymman.2020.08.012"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00520\u2010015\u20102995\u2010z"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/scs.12463"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1188\/17.ONF.645\u2010649"},{"key":"e_1_2_11_19_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ejon.2011.09.001"},{"key":"e_1_2_11_20_1","first-page":"137","article-title":"Dyadic coping: a systemic\u2010transactional view of stress and coping among couples: theory and empirical findings","volume":"47","author":"Bodenmann G","year":"1997","journal-title":"Rev Eur Psychol Appl"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2015.07.002"},{"key":"e_1_2_11_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpsyg.2019.01498"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamaoncol.2019.4728"},{"key":"e_1_2_11_24_1","volume-title":"Uncertainty in Illness Scales Manual","author":"Mishel MH","year":"1997"},{"key":"e_1_2_11_25_1","volume-title":"Dyadic Data Analysis","author":"Kenny DA","year":"2006"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2012.09.006"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010018\u20101051\u20103"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.3289"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2004.04.018"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12160\u2010017\u20109875\u20103"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.1007\/s12160\u2010015\u20109743\u2010y"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1479-3555(02)02004-8"},{"key":"e_1_2_11_33_1","volume-title":"Statistical Power Analysis for the Behavioral Sciences","author":"Cohen J","year":"1988"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0b013e31819f1aab"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1097\/NCC.0000000000000159"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/00002820\u2010200409000\u201000001"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1188\/13.ONF.82\u201092"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.1207\/s15327558ijbm1304_3"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1002\/pon.871"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1002\/cncr.23114"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.soncn.2019.06.004"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102407\u201012\u2010279"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/0272989X11393976"}],"container-title":["Psycho-Oncology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.5895","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/pon.5895","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/pon.5895","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,24]],"date-time":"2023-08-24T13:28:17Z","timestamp":1692883697000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/pon.5895"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,2,20]]},"references-count":42,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2022,6]]}},"alternative-id":["10.1002\/pon.5895"],"URL":"https:\/\/doi.org\/10.1002\/pon.5895","archive":["Portico"],"relation":{},"ISSN":["1057-9249","1099-1611"],"issn-type":[{"value":"1057-9249","type":"print"},{"value":"1099-1611","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,2,20]]},"assertion":[{"value":"2021-07-09","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-01-21","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-02-20","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}