Relationship between intolerance of uncertainty, family resilience, and fertility anxiety in childbearing-aged patients with Crohn’s disease and their spouses

Patients with Crohn's disease (CD) and their spouses experience varying levels of fertility anxiety. This study aimed to explore the effects of intolerance of uncertainty and family resilience on the fertility anxiety of reproductive-aged CD patients and their spouses, providing an effective basis for formulating plans to reduce the level of fertility anxiety. This cross-sectional study employed the actor-partner interdependence mediation model. Between May and December 2024, 208 pairs of childbearing-aged CD patients and their spouses were recruited from a tertiary hospital in Nanjing, China. Data were collected via a general demographic questionnaire, the Intolerance of Uncertainty Scale-12, the Family Resilience Assessment Scale, and the Fertility Problem Inventory. Patients' fertility anxiety was positively associated with both their own intolerance of uncertainty and that of their spouse, whereas it was negatively correlated with family resilience. Conversely, spousal fertility anxiety was negatively associated with personal tolerance of uncertainty and family resilience but positively correlated with self-intolerance of uncertainty. The mediation model revealed that intolerance of uncertainty in both patients and spouses directly and positively predicted their fertility anxiety. Furthermore, intolerance of uncertainty influences fertility anxiety indirectly through the mediating role of family resilience. Notably, spouses' intolerance of uncertainty positively affects patients' fertility anxiety. Conversely, patients' intolerance of uncertainty indirectly influences their fertility anxiety via the mediating effect of patients' family resilience. This study highlights the bidirectional nature of fertility anxiety in childbearing-aged CD patients and their spouses. The intolerance of uncertainty exhibited by both patients and spouses significantly contributes to fertility anxiety, with family resilience acting as a key mediator. These findings provide empirical support for interventions aimed at addressing fertility anxiety at the dyad level, targeting both patients and their spouses.