Perceived illness uncertainty and its associated factors among oesophageal cancer patients: a cross-sectional study based on the health ecology model.

OBJECTIVE: Based on the health ecology model, this study investigates the current status of illness uncertainty perception in oesophageal cancer patients scheduled for surgery and analyses its associated factors. DESIGN: A cross-sectional study. SETTING: The study was conducted in the Department of Thoracic Surgery at a tertiary hospital in Suzhou, China, from May 2024 to December 2025. PARTICIPANTS: A total of 230 oesophageal cancer patients scheduled for surgery were recruited using convenience sampling. All participants were hospitalised in the Department of Thoracic Surgery during the study period and met the inclusion criteria for the research. PRIMARY AND SECONDARY OUTCOME MEASURES: The primary outcome was perceived illness uncertainty, measured using the Short Intolerance of Uncertainty Scale. Secondary outcomes included state anxiety (assessed by the State Anxiety Inventory), medical coping styles (assessed by the Medical Coping Modes Questionnaire) and perceived social support (assessed by the Perceived Social Support Scale). Sociodemographic and clinical characteristics were also collected using a self-designed general information questionnaire. RESULTS: A total of 230 patients were included. The total score for perceived illness uncertainty was 36.25±5.36. Multiple linear regression analysis showed that receipt of neoadjuvant therapy (β=-0.131, 95% CI -2.524 to -0.965, p<0.001), shorter daily sleep duration (β=-0.074, 95% CI -1.373 to -0.014, p=0.045), high state anxiety (β=0.428, 95% CI 0.222 to 0.357, p<0.001), avoidance coping tendency (β=0.123, 95% CI 0.104 to 0.442, p=0.002) and resignation coping tendency (β=0.120, 95% CI 0.061 to 0.589, p=0.016) and poor social support (β=-0.269, 95% CI -0.245 to -0.115, p<0.001) were the prominent factors associated with patients' perceived illness uncertainty, collectively explaining 82.1% of the total variance. CONCLUSIONS: Oesophageal cancer patients scheduled for surgery exhibit a high level of perceived illness uncertainty, which is related to multiple correlates across various levels, including personal characteristics, behavioural traits and interpersonal networks. Preoperative receipt of neoadjuvant therapy, shorter daily sleep duration, high anxiety state, avoidance coping tendency, resignation coping tendency and poor social support are identified as associated factors. Nursing staff should provide targeted interventions to reduce patients' uncertainty and enhance their psychological adaptation, thereby facilitating postoperative recovery and improving quality of life.