The moderating role of family functioning and self-compassion in the relation between intolerance of uncertainty and parental clinical decision-making style

Parental shared decision-making in pediatric medical care can influence treatment adherence, parental well-being, and clinical outcomes. However, parents vary in their clinical decision-making style, which may be influenced by psychological and contextual factors. In this study we examined the association between intolerance of uncertainty and parental clinical decision-making style (PCDMS), with a focus on the moderating roles of family functioning and self-compassion. A moderated moderation model was tested among 219 parents actively involved in their child's healthcare. Findings revealed that intolerance of uncertainty was negatively associated with a shared-active decision-making style. However, this relationship was moderated by family functioning: When family functioning was high, greater intolerance of uncertainty was associated with a more shared-active role in decision-making, whereas when family functioning was low, greater intolerance of uncertainty was associated with a more passive role. Additionally, self-compassion further moderated this interaction, amplifying the role of family functioning. Specifically, when self-compassion was high, family functioning played a stronger role in mitigating the negative effects of uncertainty intolerance. These findings provide novel insights into the psychological mechanisms underlying PCDMS in pediatric healthcare. The study highlights the importance of interventions aimed at strengthening family functioning and self-compassion to support parents in navigating medical decision-making processes.