~ 333 ~ International Journal of Advance Research in Medical Surgical Nursing 2025; 7(1): 333-344 E-ISSN: 2663-2268 P-ISSN: 2663-225X www.surgicalnursingjournal.com IJARMSN 2025; 7(1): 333-344 Received: 10-03-2025 Accepted: 15-04-2025 Laishram Vidyalakshmi Christian Institute of Health Sciences and Research, Chumukedima, Nagaland, India Dr. Premila Lee Retired Professor and HOD, Medical Surgical Nursing, Christian Medical College, Vellore, Tamil Nadu, India Sonia P Abraham and Professor, Medical Surgical Nursing, Christian Medical College, Vellore, Tamil Nadu, India Dr. Philip Joseph Senior Professor and former HOD, Department of Hepato- Pancreato-Biliary (HPB) Surgery, Christian Medical College, Vellore, Tamil Nadu, India Jhansi Biostatistician, Christian Medical College, Vellore, Tamil Nadu, India Corresponding Author: Laishram Vidyalakshmi Christian Institute of Health Sciences and Research, Chumukedima, Nagaland, India A descriptive comparative study on illness uncertainty and anxiety of patients undergoing major surgery for malignant and non-malignant conditions in selected wards of a tertiary hospital in Tamil Nadu, South India Laishram Vidyalakshmi, Premila Lee, Sonia P Abraham, Philip Joseph and Jhansi DOI: https://www.doi.org/10.33545/surgicalnursing.2025.v7.i1e.257 Abstract Background & Aims: Undergoing surgery causes illness uncertainty and anxiety. Pre-operative uncertainty and anxiety affects the postoperative recovery and also increases the risk of post-operative complications, necessitating the need to intervene. Every year around 310 million people undergo surgeries globally for both malignant and non-malignant causes. Do all patients undergoing surgery for both malignant and non-malignant conditions experience illness uncertainty and anxiety similarly? Hence the current study was undertaken to compare illness uncertainty and anxiety of patients undergoing major surgery for malignant and non-malignant conditions. Methods & Materials: A descriptive comparative study was undertaken involving 126 subjects, with malignant (63) and non-malignant conditions (63), in a tertiary hospital. Consecutive sampling was used to recruit subjects Translated version of Mishel Uncertainty Illness Scale (MUIS) and Hamilton Anxiety Rating Scale (HARS) were self-administered. Results: Findings revealed that subjects with non-malignant conditions experienced higher preoperative illness uncertainty and anxiety (p<0.05). Illness uncertainty and anxiety were positively correlated in both the conditions (r =0.777, 0.853; p<0.01). Age, gender, education, family income, marital status, faith in God, resilience, duration of diagnosis, and history of previous surgery, influenced the illness uncertainty and anxiety patients experienced. Conclusion: Patients adapt to the disease process over time and reconceptualise illness uncertainty in malignant conditions. However sudden occurrence and the fear of unknown could be the reason for increased illness uncertainty and anxiety in non-malignant conditions. Keywords: Illness uncertainty, anxiety, major surgery, malignant and non-malignant Introduction Every year around 310 million people undergo surgeries globally for both malignant and non-malignant causes (Dobson, 2020) [10] . The Lancet Commission for global surgery estimated 5000 surgeries per 100,000 to meet the surgical burden in low and middle income countries. In India, a total of 4642 surgeries are performed per year for a population of 88,273 against the estimated total of 3646 surgeries per 100,000 (Bhandarkar, Gadgil, Patil, Mohan & Roy, 2021) [4] . The tertiary care center where the study was conducted, performs an average of 185 surgeries daily, out of which approximately 100-120 are major surgeries. A surgical procedure is a traumatic treatment associated with bleeding, pain, risk of morbidity and death (Maranets & Kain, 1999) [31] . High pre-operative uncertainty and anxiety affects the postoperative recovery (Kagan & Bar-Tal, 2008; Ismail, So & Li., 2010) [26, 24] and also increases the risk of post-operative complications (Wondmieneh, 2020; Mulugeta, Ayana, Sintayehu, Dessie, & Zewdu, 2018) [46, 33] . Lower the uncertainty, higher is the possibility of activating coping mechanisms with acceptance of illness and a reflexive attitude concerning actions towards reducing anxiety or depression during hospitalization. Identifying the uncertainty level enables us to help patients adopt appropriate coping mechanisms and can also be useful in developing strategies to reduce anxiety level and promote coping mechanisms (Giammanco & Gitto, 2016) [18] . Lan,