331例首次经体外受精-胚胎移植患者配偶心理困扰现状及影响因素分析
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摘要
目的探讨首次经体外受精-胚胎移植患者配偶的心理困扰状况,分析其影响因素。方法采用方便抽样方法,选取2017年4—12月在济南市3家医院首次采用体外受精-胚胎移植患者配偶为研究对象。采用一般资料调查表、简易心理状况调查表、心理弹性量表、简易应对方式量表、领悟社会支持量表及神经质人格分量表对331例首次体外受精-胚胎移植患者配偶进行调查,采用等级Logistic回归分析对其心理困扰的影响因素。结果 331例首次体外受精-胚胎移植患者配偶,其心理困扰得分为(19.72±5.44)分,其中74.0%的男性具有不同程度的心理困扰。等级Logistic回归结果显示,治疗时长(OR=1.150,95%CI:0.051～0.228)、消极应对方式(OR=1.107,95%CI:0.046～0.157)、神经质人格(OR=1.108,95%CI:0.055～0.151)是心理困扰的危险因素;心理弹性(OR=0.941,95%CI:-0.101～-0.021)是心理困扰的保护因素。结论首次经体外受精-胚胎移植患者配偶普遍存在心理困扰,治疗时长、消极应对方式、神经质人格是心理困扰的危险因素;心理弹性是心理困扰的保护因素。建议医护人员对治疗时间长、有神经质倾向的首次经体外受精-胚胎移植患者配偶应给予更多的关注,同时应鼓励该人群学会合理宣泄自己的情绪,从而减少消极应对方式;此外,寻找切实有效方式来提高该人群的心理弹性水平。
Objective To explore psychological distress of patient's spouses treated firstly by in vitro fertilization and embryo transfer(IVF-ET) and analyze its influence factors. Methods A convenience sampling study was conducted. Patient's spouses treated firstly by IVF-ET admitted to three hospitals in Jinan from April 2017 to December 2017 were enrolled. The informntion were collected from subjects(n=331) by using general information questionnaire, Mental Health Status Scale, Connor-Davidson Resilience Scale, Simplified Coping Style Questionnaire, Perceived Social Support Scale and Subscale of Neurotic Personality. Ordinal logistic regression was performed to analyze statistics data. Results The total score of psychological distress was 19.72 ±5.44, and the prevalence of psychological distress was 74.0%. Ordinal logistic regression indicated treatment time(OR=1.150, 95%CI: 0.051～0.228),negative coping style(OR =1.107, 95% CI: 0.046 ～0.157) and neuroticism(OR =1.108, 95% CI: 0.055 ～0.151) were risk factors of psychological distress; while resilience(OR=0.941, 95%CI:-0.101～-0.021) was the protective factor. Conclusion The psychological distress status is relatively general among patient's spouses treated firstly by IVF-ET. The treatment time, negative coping style and neuroticism were risk factors of psychological distress; while resilience was the protective factor. More attention should be paid to patient's spouses treated firstly by IVF-ET who had more treatment time or higher scores of neuroticism. Encourage patient 's spouses to express their emotions and reduce negative coping styles. Relevant intervention courses could be carried out to improve the psychological distress, relevant intervention courses could be carried out to improve the psychological distress.
Objective To explore psychological distress of patient's spouses treated firstly by in vitro fertilization and embryo transfer(IVF-ET) and analyze its influence factors. Methods A convenience sampling study was conducted. Patient's spouses treated firstly by IVF-ET admitted to three hospitals in Jinan from April 2017 to December 2017 were enrolled. The informntion were collected from subjects(n=331) by using general information questionnaire, Mental Health Status Scale, Connor-Davidson Resilience Scale, Simplified Coping Style Questionnaire, Perceived Social Support Scale and Subscale of Neurotic Personality. Ordinal logistic regression was performed to analyze statistics data. Results The total score of psychological distress was 19.72 ±5.44, and the prevalence of psychological distress was 74.0%. Ordinal logistic regression indicated treatment time(OR=1.150, 95%CI: 0.051～0.228),negative coping style(OR =1.107, 95% CI: 0.046 ～0.157) and neuroticism(OR =1.108, 95% CI: 0.055 ～0.151) were risk factors of psychological distress; while resilience(OR=0.941, 95%CI:-0.101～-0.021) was the protective factor. Conclusion The psychological distress status is relatively general among patient's spouses treated firstly by IVF-ET. The treatment time, negative coping style and neuroticism were risk factors of psychological distress; while resilience was the protective factor. More attention should be paid to patient's spouses treated firstly by IVF-ET who had more treatment time or higher scores of neuroticism. Encourage patient 's spouses to express their emotions and reduce negative coping styles. Relevant intervention courses could be carried out to improve the psychological distress, relevant intervention courses could be carried out to improve the psychological distress.
引文
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[19]Chou K L.Assessing Chinese Adolescents’Social Support:The MultidimensionaL Scale of Perceived Social Support[J].Pers Indiv Differ,2000,28(2):299-307.DOI:10.1016/S0191-8869(99)00098-7.
[20]John O P,Srivastava S.The Big Five Trait Taxonomy:History,Measurement,and Theoretical Perspectives[EB/OL].(2006-10-30)[2018-12-12].https://www.ocf.berkeley.edu/~johnlab/pdfs/john&srivastava,1999.pdf.
[21]Carciofo R,Yang J,Song N,et al.Psychometric Evaluation of Chinese-language 44-Item and 10-Item Big Five Personality Inventories,Including Correlations with Chronotype,Mindfulness and Mind Wandering[J].PLoS One,2016,11(2):e0149963.DOI:10.1371/journaL.pone.0149963.e CoLLection 2016.
[22]刘双金,胡义秋,孙焕良.生活事件对大学生抑郁的影响:神经质与应对方式的链式中介作用[J].中国临床心理学杂志,2018,26(6):1230-1233.DOI:10.16128/j.cnki.1005-3611.2018.06.040.
[23]周飞京,董悦芝.初诊不孕不育夫妇中男性的性压力现况调查[J].中华护理杂志,2016,51(4):499-501.DOI:10.3761/j.issn.0254-1796.2016.04.024.
[24]Kazandi M,Gunday O,Mermer T K,et aL.The Status of Depression and Anxiety in Infertile Turkish Couples[J].I-ran J Reprod Med,2011,9(2):99-104.
[25]AL-Asadi,J N,Hussein Z B.Depression among Infertile Women in Basrah,Iraq:Prevalence and Risk Factors[J].JChin Med Assoc,2015,78(11):673-677.DOI:10.1016/j.jcma.2015.07.009.
[26]余淑嫒,翟惠敏.综合医院低年资护士心理健康与应对方式及社会支持的相关性研究[J].护理学报,2013,20(5B):1-4.DOI:10.16460/j.issn1008-9969.2013.10.014.
[27]Matzka M,Mayer H,K觟ck-Hódi S,et al.Relationship between Resilience,PsychologicaL Distress and PhysicaL Activity in Cancer Patients:A Cross-sectionaL Observation Study[J].PLoS One,2016,11(4):e0154496.DOI:10.1371/journaL.pone.0154496.eCoLLection 2016.
[28]Luthar S S,CurLee A,Tye SJ,et al.Fostering Resilience among Mothers under Stress:“Authentic Connections Groups”for Medical Professionals[J].Womens Health Issues,2017,27(3):382-390.DOI:10.1016/j.whi.2017.02.007.
[29]Foureur M,BesLey K,Burton G,et aL.Enhancing the Resilience of Nurses and Midwives:Pilot of a Mindfulnessbased Program for Increased Health,Sense of Coherence and Decreased Depression,Anxiety and Stress[J].Contemp Nurse,2013,45(1):114-125.DOI:10.5172/conu.2013.45.1.114.
[30]席畅,凌宇,钟明天,等.神经质在大学生应激与抑郁关系中的调节作用[J].中国临床心理学杂志,2016,24(4):636-639.DOI:10.16128/j.cnki.1005-3611.2016.04.013.
[2]Zhou Z,Zheng D,Wu H,et aL.EpidemioLogy of InfertiLity in China:A Population-based Study[J].BJOG,2018,125(4):432-441.DOI:10.1111/1471-0528.14966.
[3]Demyttenaere K,Nijs P,Evers-Kiebooms G,et aL.Coping,Ineffectiveness of Coping and the PsychoendocrinoLogicaLStress Responses During In-Vitro FertiLization[J].J Psychosom Res,1991,35(2/3):231-243.
[4]康晓菲,方跃艳,赵迪,等.不孕女性患者知觉压力在正念水平与心理困扰间的中介作用[J].山东大学学报(医学版),2017,55(9):105-109.DOI:10.6040/j.issn.1671-7554.0.2017.228.
[5]张琼,陈丹,蒋玲,等.接受体外受精-胚胎移植治疗女患者个人社会心理因素对治疗结局的影响[J].护理学报,2016,23(20):1-4.DOI:10.16460/j.issn1008-9969.2016.20.001.
[6]孙洪梅,钱卫平,刘波澜,等.118例体外受精-胚胎移植助孕患者心理症状分析[J].护理学报,2015,22(14):70-72.DOI:10.16460/j.issn1008-9969.2015.14.070.
[7]张琼,陈丹,蒋俐萍,等.行体外受精-胚胎移植女性患者焦虑抑郁现状及影响因素分析[J].护理学报,2017,24(14):43-47.DOI:10.16460/j.issn1008-9969.2017.14.043.
[8]KessLer R C,Andrews G,CoLpe L J,et aL.Short Screening Scales to Monitor Population Prevalences and Trends in Non-specific Psychological Distress[J].Psychol Med,2002,32(6):959-976.DOI:10.1017/S0033291702006074.
[9]徐凌忠,王建新,孙辉,等.Kessler 10在我国的首次应用研究及其重要意义[J].卫生软科学,2005,19(6):410-412.DOI:10.3969/j.issn.1003-2800.2005.06.013.
[10]周成超,楚洁,王婷,等.简易心理状况评定量表kessler10中文版的信度和效度评价[J].中国临床心理学杂志,200816(6):627-629.DOI:10.16128/j.cnki.1005-3611.2008.06.026.
[11]孔令华.不孕不育夫妇情绪困扰及其影响因素的二元交互模型构建[D].济南:山东大学,2017.
[12]Campbell-sills L,Stein M B.Psychometric Analysis and Refinement of the Connor-davidson Resilience Scale(CD-RISC):Validation of a 10-Item Measure of Resilience[J].JTrauma Stress,2010,20(6):1019-1028.DOI:10.1002/jts.20271.
[13]Duan W,Guo P,Gan P.Relationships among Trait Resilience,Virtues,Post-Traumatic Stress Disorder,and Post-Traumatic Growth[J].PLoS One,2015,10(5):e0125707.DOI:10.1371/journaL.pone.0125707.eCoLLection 2015.
[14]Yu X and Zhang J.Factor Analysis and Psychometric E-valuation of the Connor-davidson Resiliencescale(CD-RISC)with Chinese People[J].Soc Behav Personal,2007,35(1):19-30.DOI:10.2224/sbp.2007.35.1.19.
[15]Wang L,Shi Z,Zhang Y,et al.Psychometric Properties of the 10-Item Connor-davidson Resilience Scale in Chinese Earthquake Victims[J].Psychiatry Clin Neurosci,2010,64(5):499-504.DOI:10.1111/j.1440-1819.2010.02130.x.
[16]Lazarus R S,Delongis A,Folkman S,et al.Stress and Adaptational Outcomes.The Problem of Confounded Measures[J].Am PsychoL,1985,40(7):770-785.
[17]解亚宁.简易应对方式量表信度和效度的初步研究[J]中国临床心理学杂志,1998,6(2):114-115.DOI:10.16128/j.cnki.1005-3611.1998.02.018.
[18]Zimet G D,Dahlem N W,Zimet S G,et aL.The MultidimensionaL Scale of Perceived Social Support[J].J Pers Assess,1988(52):30-41.DOI:10.1207/s15327752jpa5201_2.
[19]Chou K L.Assessing Chinese Adolescents’Social Support:The MultidimensionaL Scale of Perceived Social Support[J].Pers Indiv Differ,2000,28(2):299-307.DOI:10.1016/S0191-8869(99)00098-7.
[20]John O P,Srivastava S.The Big Five Trait Taxonomy:History,Measurement,and Theoretical Perspectives[EB/OL].(2006-10-30)[2018-12-12].https://www.ocf.berkeley.edu/~johnlab/pdfs/john&srivastava,1999.pdf.
[21]Carciofo R,Yang J,Song N,et al.Psychometric Evaluation of Chinese-language 44-Item and 10-Item Big Five Personality Inventories,Including Correlations with Chronotype,Mindfulness and Mind Wandering[J].PLoS One,2016,11(2):e0149963.DOI:10.1371/journaL.pone.0149963.e CoLLection 2016.
[22]刘双金,胡义秋,孙焕良.生活事件对大学生抑郁的影响:神经质与应对方式的链式中介作用[J].中国临床心理学杂志,2018,26(6):1230-1233.DOI:10.16128/j.cnki.1005-3611.2018.06.040.
[23]周飞京,董悦芝.初诊不孕不育夫妇中男性的性压力现况调查[J].中华护理杂志,2016,51(4):499-501.DOI:10.3761/j.issn.0254-1796.2016.04.024.
[24]Kazandi M,Gunday O,Mermer T K,et aL.The Status of Depression and Anxiety in Infertile Turkish Couples[J].I-ran J Reprod Med,2011,9(2):99-104.
[25]AL-Asadi,J N,Hussein Z B.Depression among Infertile Women in Basrah,Iraq:Prevalence and Risk Factors[J].JChin Med Assoc,2015,78(11):673-677.DOI:10.1016/j.jcma.2015.07.009.
[26]余淑嫒,翟惠敏.综合医院低年资护士心理健康与应对方式及社会支持的相关性研究[J].护理学报,2013,20(5B):1-4.DOI:10.16460/j.issn1008-9969.2013.10.014.
[27]Matzka M,Mayer H,K觟ck-Hódi S,et al.Relationship between Resilience,PsychologicaL Distress and PhysicaL Activity in Cancer Patients:A Cross-sectionaL Observation Study[J].PLoS One,2016,11(4):e0154496.DOI:10.1371/journaL.pone.0154496.eCoLLection 2016.
[28]Luthar S S,CurLee A,Tye SJ,et al.Fostering Resilience among Mothers under Stress:“Authentic Connections Groups”for Medical Professionals[J].Womens Health Issues,2017,27(3):382-390.DOI:10.1016/j.whi.2017.02.007.
[29]Foureur M,BesLey K,Burton G,et aL.Enhancing the Resilience of Nurses and Midwives:Pilot of a Mindfulnessbased Program for Increased Health,Sense of Coherence and Decreased Depression,Anxiety and Stress[J].Contemp Nurse,2013,45(1):114-125.DOI:10.5172/conu.2013.45.1.114.
[30]席畅,凌宇,钟明天,等.神经质在大学生应激与抑郁关系中的调节作用[J].中国临床心理学杂志,2016,24(4):636-639.DOI:10.16128/j.cnki.1005-3611.2016.04.013.