Social support, coping, and illness uncertainty among parents of children with cleft lip and/or palate: A cross-sectional mediation analysis.

OBJECTIVE: To identify factors associated with illness uncertainty among parents of children with cleft lip and/or palate and to explore indirect associations between social support and illness uncertainty through coping style. METHODS: In this cross-sectional study, 190 parents of children with cleft lip and/or palate were recruited from a tertiary hospital in China between July 2023 and September 2024. Data were collected using the Parents' Perception of Uncertainty Scale, the Social Support Rating Scale, and the Simplified Coping Style Questionnaire. Univariate analysis, multiple linear regression, and exploratory bootstrap mediation analysis were performed. RESULTS: The mean illness uncertainty score was 83.58 ± 8.71. In multivariable analyses, older child age (B = 0.395, 95% confidence interval [0.121, 0.669], p = 0.005) and ethnic minority status (B = 4.110, 95% confidence interval [0.235, 7.990], p = 0.038) were independently associated with higher illness uncertainty. Positive coping showed a negative association with illness uncertainty and became significant in the sensitivity analyses (B = -0.378, 95% confidence interval [-0.613, -0.144], p = 0.002). Social support was not directly associated with illness uncertainty; however, exploratory mediation analyses suggested indirect associations through positive coping for total, subjective, and objective support, with indirect effects ranging from -0.126 to -0.078. CONCLUSIONS: Illness uncertainty is a relevant psychological issue for parents during the prolonged treatment course for cleft lip and/or palate. Pediatric nurses should provide ongoing, culturally sensitive, and stage-specific support and consider parents' coping styles when identifying families at greater risk of illness uncertainty.