KMAN Publication Inc. Quality of Life and Health Sciences 2 Serial Number 4 2026 04 01 Disease Uncertainty and Quality of Life Among Patients With Inflammatory Bowel Disease: The Mediating Role of Anxiety and Health Literacy Disease Uncertainty and Quality of Life Among Patients With Inflammatory Bowel Disease: The Mediating Role of Anxiety and Health Literacy 1 15 10.61838/56mqgh55 EN Journal Article 2026 01 07 <table> <tbody> <tr> <td> <p><strong>Objective:</strong> This study aimed to examine the relationship between disease uncertainty and quality of life among Canadian adults with inflammatory bowel disease and to determine the mediating roles of anxiety and health literacy in this relationship.</p> <p><strong>Methods and Materials: </strong>This descriptive-correlational study was conducted using a cross-sectional predictive design. The study population consisted of adults with inflammatory bowel disease in Canada, and the final sample included 326 patients recruited from gastroenterology clinics, outpatient digestive disease centers, and patient support networks. Data were collected using a demographic and clinical information form, the Mishel Uncertainty in Illness Scale, the Inflammatory Bowel Disease Questionnaire, the Generalized Anxiety Disorder-7 scale, and the Health Literacy Questionnaire. Data were analyzed using SPSS and AMOS. Pearson correlation coefficients were used to examine relationships among the variables, and structural equation modeling was applied to test the direct and indirect effects of disease uncertainty on quality of life through anxiety and health literacy. The significance of indirect effects was examined using the bootstrap method with 5,000 resamples and 95% confidence intervals.</p> <p><strong>Findings: </strong>Disease uncertainty was significantly and negatively correlated with quality of life (r = -0.61, p &lt; 0.001) and health literacy (r = -0.49, p &lt; 0.001), and significantly positively correlated with anxiety (r = 0.58, p &lt; 0.001). Anxiety was negatively associated with quality of life (r = -0.67, p &lt; 0.001), while health literacy was positively associated with quality of life (r = 0.52, p &lt; 0.001). The structural model showed acceptable fit. Disease uncertainty had significant direct effects on anxiety (β = 0.58, p &lt; 0.001), health literacy (β = -0.49, p &lt; 0.001), and quality of life (β = -0.28, p &lt; 0.001). Anxiety (β = -0.43, p &lt; 0.001) and health literacy (β = 0.24, p &lt; 0.001) significantly predicted quality of life. Bootstrap analysis confirmed significant indirect effects through anxiety and health literacy.</p> <p><strong>Conclusion: </strong>Disease uncertainty was associated with poorer quality of life among patients with inflammatory bowel disease, and this relationship was partially mediated by increased anxiety and reduced health literacy.</p> </td> </tr> </tbody> </table> https://journals.kmanpub.com/index.php/qlhs/article/download/5772/10972