SynthesisAge and ageing2022
Total uncertainty: a systematic review and thematic synthesis of experiences of uncertainty in older people with advanced multimorbidity, their informal carers and health professionals.
Synthesis in Age and ageing, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 24 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
24 citing papers in PubMed, 1 synthesis or guideline pooled it, 30 citations in OpenAlex.
- Longing for continuity: A systematic review and thematic synthesis of qualitative research on the experience of older people living with chronic illness towards the end of life.Social science & medicine (1982) · 2026Pooled it
- Communication about incurable illness and remaining life between spouses and patients with incurable illness receiving specialized home care: effects of a family caregiver-targeted web-based psycho-educational intervention.BMC palliative care · 2024Trial
- Exploring Pathways to Optimise Care in malignant bowel obstruction (EPOC): A realist review of shared decision-making with people with advanced cancer and severe symptoms.Palliative medicine · 2026Review
- Intensive care under uncertainty: a qualitative study of how older patients and their relatives wish to contribute to decision-making.European geriatric medicine · 2026Observational
- Admission to intensive care: a matter of shared decision-making in the very old?European geriatric medicine · 2026Review
- What Should We Aim for when Addressing Uncertainty from Serious Illness? A Stakeholder Focus Group Study.Journal of general internal medicine · 2026Article
- Family carers' experiences of serious illness conversations in haematological malignancies - a qualitative interview study.BMC palliative care · 2026Article
- New horizons in advance care planning: narratives, identity and cultural humility.Age and ageing · 2026Review
- Holistic Psychotherapeutic Approach in Elderly Burn Patients: A Consultation-liaison Psychiatry Case Series Integrating Supportive, Family-involved and Spiritual Interventions.Annals of burns and fire disasters · 2026Article
- "We do what needs to be done": caregivers' experiences of healthcare and support for people with multiple long-term conditions in the last year of life.BMC palliative care · 2026Article
- Advancing a patient-centered and holistic approach for older patients with frailty in a vascular surgical department: a quality improvement initiative.European geriatric medicine · 2026Article
- Good care for older people at the end of life: Shared responsibilities, flexible boundaries.Future healthcare journal · 2026Article
- Complexities in supportive care for people with metastatic breast cancer: a qualitative study.Journal of cancer survivorship : research and practice · 2026Article
- Five-year mortality and functional trajectories in older survivors of intensive care compared to the general population.Intensive care medicine · 2025Observational
- 'I am old, and I will rather abandon life with my eyes open': a qualitative study of Norwegians aged 80 and older explaining their intensive care unit admission preferences.Age and ageing · 2025Article
- Communicating prognostic uncertainties in advanced multimorbidity: a multimethod qualitative study to co-design practice recommendations.European geriatric medicine · 2025Article
- Exploring readiness for advance care planning in Japan: A qualitative interview study with older adults with frailty, family caregivers, and health and social care practitioners in the homecare setting.Palliative care and social practice · 2025Article
- The impact of living with multiple long-term conditions (multimorbidity) on everyday life - a qualitative evidence synthesis.BMC public health · 2024Article
- Comfort-Promoting Interventions for the Elderly in Hospital Settings.Geriatrics (Basel, Switzerland) · 2024Article
- Prognostic communication in amyotrophic lateral sclerosis: findings from a Nationwide Italian survey.Neurological sciences : official journal of the Italian Neurological Society and of the Italian Society of Clinical Neurophysiology · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
7 authors at 1 institution in 1 country.
Funding
Abstract
objectivesuncertainty pervades the complex illness trajectories experienced by older adults with multimorbidity. Uncertainty is experienced by older people, their informal carers and professionals providing care, yet is incompletely understood. We aimed to identify and synthesise systematically the experience of uncertainty in advanced multimorbidity from patient, carer and professional perspectives.
designsystematic literature review of published and grey qualitative literature from 9 databases (Prospero CRD 42021227480).
participantsolder people with advanced multimorbidity, and informal carers/professionals providing care to this group. Exclusion criteria: early multimorbidity, insufficient focus on uncertainty. ANALYSIS: weight-of-evidence assessment was used to appraise included articles. We undertook thematic synthesis of multi-perspective experiences and response to uncertainty.
resultsfrom 4,738 unique search results, we included 44 articles relating to 40 studies. 22 focused on patient experiences of uncertainty (n = 460), 15 on carer experiences (n = 197), and 19 on health professional experiences (n = 490), with 10 exploring multiple perspectives. We identified a shared experience of 'Total Uncertainty' across five domains: 'appraising and managing multiple illnesses'; 'fragmented care and communication'; 'feeling overwhelmed'; 'uncertainty of others' and 'continual change'. Participants responded to uncertainty by either active (addressing, avoiding) or passive (accepting) means.
conclusionsthe novel concept of 'Total Uncertainty' represents a step change in our understanding of illness experience in advanced multimorbidity. Patients, carers and health professionals experienced uncertainty in similar domains, suggesting a shared understanding is feasible. The domains of total uncertainty form a useful organising framework for health professionals caring for older adults with multimorbidity.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.