Developing a theoretical definition of self-organization: A principle-based concept analysis in the context of uncertainty in chronic illness

AIM: To develop a theoretical definition of self-organization to increase the understanding of the Reconceptualized Uncertainty in Illness Theory (RUIT).

BACKGROUND: Mishel described the change of the uncertainty appraisal over time in people with a chronic illness by means of the RUIT. Therefore, she introduced the concept of self-organization. However, its meaning is difficult to comprehend because its descriptions remained highly abstract.

DESIGN: A principle-based concept analysis.

DATA SOURCE: Entries of lexicons and journal publications, explicitly or implicitly addressing self-organization in the context of any social phenomenon.

REVIEW METHODS: We conducted a conceptually driven literature search in lexicons and four databases and performed citation tracking.

RESULTS: Self-organization stands for a transition between psychological instability and psychological adjustment. It is conditioned by illness-related obstacles or uncertainties that are perceived as life-threatening. This adaptation process shows overlaps with cognitive reframing and is promoted by time, resilience, social support, and positive development of the disease. It leads to empowerment and a new perspective of life and uncertainty.

CONCLUSIONS: We enhanced the understanding of the RUIT by developing a theoretical definition of self-organization on a lower level of abstraction and by proposing a new approximation for the operationalization by means of cognitive reframing.