How Tolerance of Uncertainty Relates to Well-Being in Japanese Primary Care Physicians: A Cross-Sectional Study

Medical uncertainty is inherent in clinical practice, especially in primary care where clinicians regularly face multimorbidity, ambiguous symptoms, and unpredictable care courses. Although tolerance of uncertainty (TU) has been associated internationally with resilience, job satisfaction, and decision-making, little is known about its relationship to physician well-being in Japan. In a medical culture that emphasizes precision and decisiveness, navigating uncertainty may be psychologically challenging. This study examined the association between TU and two dimensions of well-being-subjective well-being (SWB) and eudaimonic well-being (EWB)-among Japanese primary care physicians.

We conducted a cross-sectional online survey from March 1 to 31, 2023, targeting physicians on the Japan Primary Care Association mailing list (N = 4,207). The questionnaire included demographic items and three validated scales: the Short Intolerance of Uncertainty Scale (SIUS), the Subjective Well-Being Scale (SWBS), and the Eudaimonic Well-Being Scale (EWBS). One free-text item explored emotional responses to high-uncertainty situations. Quantitative data were analyzed using correlation analysis and structural equation modeling (SEM), and qualitative responses underwent thematic analysis.

Out of 152 responses, 150 were valid. The SIUS score showed a significant negative correlation with both SWBS (r = -0.433, P < 0.001) and EWBS (r = -0.259, P = 0.001). SEM confirmed these associations, with path coefficients of -0.420 (SWBS) and -0.256 (EWBS), both P < 0.001. Taken together, these results indicate that higher intolerance of uncertainty was associated with lower well-being; conversely, greater tolerance of uncertainty (TU) was positively associated with both subjective and eudaimonic aspects of well-being. Thematic analysis of free-text responses revealed four themes: (1) Positive recognition of uncertainty, (2) Acceptance of uncertainty, (3) Coping strategies, and (4) Growth through uncertainty.

Higher tolerance of uncertainty is positively associated with both subjective and eudaimonic well-being among Japanese primary care physicians. These findings suggest that fostering TU may enhance psychological health and support professional development.