{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T02:58:37Z","timestamp":1781146717565,"version":"3.54.1"},"reference-count":43,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"funder":[{"DOI":"10.13039\/501100002467","name":"Dankook University","doi-asserted-by":"publisher","award":["R202500697"],"award-info":[{"award-number":["R202500697"]}],"id":[{"id":"10.13039\/501100002467","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Nursing &amp;amp; Health Sciences"],"published-print":{"date-parts":[[2026,3]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Women undergoing assisted reproductive technology (ART) often experience depression linked to treatment\u2010related uncertainty. This study examined whether perceived stigma mediates the relationship between uncertainty and depression and whether spousal support moderates this effect. PROCESS Macro Model 14 was used, controlling for miscarriage experience, counseling history, and spousal proactiveness. Conditional indirect effects and the moderated mediation index were assessed using bootstrapping with 95% confidence intervals. Uncertainty significantly predicted perceived stigma (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.56,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001) and depression (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.54,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.002). Perceived stigma also significantly affected depression (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.61,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009&lt;\u20090.001). However, spousal support (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u2009\u22120.09,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.617) and its interaction with stigma (\n                    <jats:italic>\u03b2<\/jats:italic>\n                    \u2009=\u20090.02,\n                    <jats:italic>p<\/jats:italic>\n                    \u2009=\u20090.913) were not significant. While indirect effects remained significant at all spousal support levels, the moderated mediation index was nonsignificant (95% CI: \u22120.15 to 0.21). Perceived stigma mediates the effect of uncertainty on depression, but spousal support does not moderate this pathway. Interventions should target uncertainty and stigma reduction to improve mental health in women undergoing ART.\n                  <\/jats:p>","DOI":"10.1111\/nhs.70305","type":"journal-article","created":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T19:45:00Z","timestamp":1771443900000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Effects of Uncertainty on Depression in Women Undergoing Assisted Reproductive Technology: The Mediating Role of Perceived Stigma and the Moderated Mediation by Spousal Support"],"prefix":"10.1111","volume":"28","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-7976-0245","authenticated-orcid":false,"given":"Miok","family":"Kim","sequence":"first","affiliation":[{"name":"Department of Nursing, College of Nursing Dankook University  Cheonan South Korea"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"e_1_2_19_2_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0242024"},{"key":"e_1_2_19_3_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.2051-5545.2009.tb00218.x"},{"key":"e_1_2_19_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/ijgo.14084"},{"key":"e_1_2_19_5_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0205009"},{"key":"e_1_2_19_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.fertnstert.2008.12.12"},{"key":"e_1_2_19_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.socscimed.2007.06.003"},{"key":"e_1_2_19_8_1","doi-asserted-by":"publisher","DOI":"10.22038\/IJOGI.2013.683"},{"key":"e_1_2_19_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jpsychores.2014.11.014"},{"key":"e_1_2_19_10_1","doi-asserted-by":"publisher","DOI":"10.1093\/humrep\/dey109"},{"key":"e_1_2_19_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.cpr.2011.05.001"},{"key":"e_1_2_19_12_1","volume-title":"Introduction to Mediation, Moderation, and Conditional Process Analysis: A Regression\u2010Based Approach","author":"Hayes A. F.","year":"2022"},{"key":"e_1_2_19_13_1","doi-asserted-by":"publisher","DOI":"10.15709\/hswr.2013.33.3.161"},{"key":"e_1_2_19_14_1","first-page":"271","article-title":"A Phenomenological Study on Infertile Experiences of Women: \u201cWaiting for Meeting\u201d","volume":"44","author":"Jeong Y. M.","year":"2017","journal-title":"Studies on Life and Culture"},{"key":"e_1_2_19_15_1","doi-asserted-by":"publisher","DOI":"10.3233\/WOR\u2010172661"},{"key":"e_1_2_19_16_1","doi-asserted-by":"publisher","DOI":"10.14744\/phd.2020.48030"},{"key":"e_1_2_19_17_1","unstructured":"Kim D. J.Hwang C.Tong H.Jeon andS.Bu.2021.\u201cGender Cognitive Analysis and Improvement Tasks for Infertile Couple Support Policy in South Korea. Korean Women's Development Institute.\u201d"},{"key":"e_1_2_19_18_1","doi-asserted-by":"publisher","DOI":"10.4040\/jkan.22068"},{"key":"e_1_2_19_19_1","doi-asserted-by":"publisher","DOI":"10.4040\/jkan.23095"},{"key":"e_1_2_19_20_1","doi-asserted-by":"publisher","DOI":"10.4069\/kjwhn.2010.16.4.370"},{"key":"e_1_2_19_21_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0015-0282(16)55633-7"},{"key":"e_1_2_19_22_1","doi-asserted-by":"publisher","DOI":"10.37990\/medr.1014220"},{"key":"e_1_2_19_23_1","doi-asserted-by":"publisher","DOI":"10.4069\/kjwhn.2020.03.15"},{"key":"e_1_2_19_24_1","doi-asserted-by":"publisher","DOI":"10.5114\/hpr.2021.107335"},{"key":"e_1_2_19_25_1","doi-asserted-by":"publisher","DOI":"10.1016\/0005\u20107967(94)00075\u2010U"},{"key":"e_1_2_19_26_1","doi-asserted-by":"publisher","DOI":"10.1146\/annurev.psych.56.091103.070137"},{"key":"e_1_2_19_27_1","doi-asserted-by":"publisher","DOI":"10.2147\/CEOR.S79513"},{"key":"e_1_2_19_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12955\u2010018\u20100904\u20101"},{"key":"e_1_2_19_29_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13104\u2010019\u20104294\u20100"},{"key":"e_1_2_19_30_1","doi-asserted-by":"publisher","DOI":"10.1177\/13591053211041185"},{"key":"e_1_2_19_31_1","unstructured":"Nam K. S.1988.\u201cA Study on the Correlation Between Spouse Support and the Body Image of Female Patients Who Have Done Mastectomy and Hysterectomy [Master's Thesis Ewha Women University].\u201d"},{"key":"e_1_2_19_32_1","doi-asserted-by":"publisher","DOI":"10.29309\/TPMJ\/2019.26.09.4019"},{"key":"e_1_2_19_33_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.apnu.2021.05.009"},{"key":"e_1_2_19_34_1","unstructured":"Park M. K.2007.\u201cA Study on Relationship Between Infertile Female Stress and Husband Support [Master's Thesis Hanyang University].\u201d"},{"key":"e_1_2_19_35_1","doi-asserted-by":"publisher","DOI":"10.4103\/jhrs.JHRS_134_17"},{"key":"e_1_2_19_36_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12888\u2010021\u201003280\u20105"},{"key":"e_1_2_19_37_1","doi-asserted-by":"publisher","DOI":"10.1097\/GCO.0000000000000261"},{"key":"e_1_2_19_38_1","doi-asserted-by":"publisher","DOI":"10.4040\/jkan"},{"key":"e_1_2_19_39_1","doi-asserted-by":"publisher","DOI":"10.7759\/cureus.30320"},{"key":"e_1_2_19_40_1","doi-asserted-by":"publisher","DOI":"10.2753\/AAE1061\u20101959360245"},{"key":"e_1_2_19_41_1","doi-asserted-by":"publisher","DOI":"10.5505\/eurjhs.2016.63634"},{"key":"e_1_2_19_42_1","doi-asserted-by":"publisher","DOI":"10.3390\/healthcare10071300"},{"key":"e_1_2_19_43_1","doi-asserted-by":"publisher","DOI":"10.1177\/02654075211044493"},{"issue":"5","key":"e_1_2_19_44_1","first-page":"531","article-title":"Evaluating Stigma Among Infertile Men and Women in Iran [in Persian]","volume":"6","author":"Younesi S. J.","year":"2006","journal-title":"Journal of Reproduction and Infertility"}],"container-title":["Nursing &amp; Health Sciences"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nhs.70305","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/nhs.70305","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/nhs.70305","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T02:25:06Z","timestamp":1781144706000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/nhs.70305"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2,18]]},"references-count":43,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,3]]}},"alternative-id":["10.1111\/nhs.70305"],"URL":"https:\/\/doi.org\/10.1111\/nhs.70305","archive":["Portico"],"relation":{},"ISSN":["1441-0745","1442-2018"],"issn-type":[{"value":"1441-0745","type":"print"},{"value":"1442-2018","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2,18]]},"assertion":[{"value":"2025-05-21","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-02","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70305"}}