沈阳市妊娠早期孕妇焦虑症状的影响因素
|
摘要
[目的]探讨沈阳市妊娠早期孕妇焦虑症状的影响因素。[方法]采用横断面研究设计,于2018年1—7月随机抽取沈阳市7所社区卫生服务中心怀孕16周前的350名孕妇进行问卷调查。运用焦虑自评量表、匹兹堡睡眠质量指数量表、妊娠压力量表、领悟社会支持量表评价孕妇的焦虑症状、睡眠质量、妊娠压力、领悟社会支持水平。应用多元线性回归分析探讨妊娠早期孕妇焦虑症状的影响因素。[结果]发放调查问卷350份,回收有效问卷309份,有效回收率为88.29%。孕妇平均年龄为(31.21±3.88)岁;焦虑自评量表的平均分为(41.99±7.45)分,其中50人有焦虑症状,占16.2%;匹兹堡睡眠质量指数量表平均分为(4.97±3.08)分,35.0%的孕妇睡眠质量不好;领悟社会支持量表平均分为(71.52±11.33)分,14.2%的孕妇处于中低水平的社会支持状态;妊娠压力量表平均分为(2.25±3.98)分,其中19.1%的孕妇有中度或重度压力。妊娠早期孕妇的妊娠压力、睡眠质量与焦虑症状呈正相关(P <0.01),领悟社会支持与焦虑症状呈负相关(P <0.01)。多元线性回归分析显示:妊娠早期孕妇焦虑症状的影响因素为睡眠质量(b=0.326),领悟社会支持(b=-0.235),妊娠压力(b=0.153)及暴露噪声环境(b=0.101)。[结论]沈阳市妊娠早期孕妇焦虑症状的影响因素为睡眠质量、领悟社会支持、妊娠压力及暴露噪声环境。可通过改善孕妇睡眠质量,降低妊娠压力,提高社会支持,减少环境噪声暴露,缓解妊娠早期孕妇的焦虑症状,提高其生命质量。
[Objective] To explore the factors associated with anxiety symptoms of women in early pregnancy in Shenyang.[Methods] A cross-sectional survey was conducted from January to July 2018 to ask a total of 350 pregnant women to complete a set of questionnaires who were less than 16 weeks of pregnancy from seven health service centers of Shenyang. The Self-rating Anxiety Scale(SAS), the Pittsburgh Sleep Quality Index(PSQI), the Pregnancy Stress Scale(PPS), and the Perceived Social Support Scale(PSSS) were used to evaluate anxiety symptoms, sleep quality, pregnancy stress, and social support, respectively. Multiple linear regression analysis was used to explore factors associated with anxiety symptoms in pregnant women. [Results] A total of 350 questionnaires were distributed and 309 returned questionnaires were valid(88.29%). The average age of study subjects was(31.21±3.88) years old; the average anxiety symptom score was 41.99±7.45, and the anxiety symptom rate was 16.2%(50/309); the average score of sleep quality was 4.97±3.08, and 35.0% of the pregnant women had poor sleep quality; the average score of perceived social support was 71.52±11.33, and 14.2% of the subjects perceived middle and low levels of social support; the average score of pregnancy stress was 2.25±3.98, and 19.1% of the women had moderate and severe stress. Pregnancy stress and sleep quality were positively correlated with anxiety symptoms(P < 0.01), while perceived social support was positively correlated with anxiety symptoms among the women in early pregnancy(P < 0.01). According to multiple linear regression analysis, the factors associated with anxiety symptoms were sleep quality(b=0.326), perceived social support(b=-0.235), pregnancy stress(b=0.153), and exposure to noise(b=0.101).[Conclusion] The influencing factors associated with anxiety symptoms of women in early pregnancy in Shenyang are sleep quality, perceived social support, pregnancy stress, and exposure to noise, which should be addressed to improve the quality of life of the mothers.
[Objective] To explore the factors associated with anxiety symptoms of women in early pregnancy in Shenyang.[Methods] A cross-sectional survey was conducted from January to July 2018 to ask a total of 350 pregnant women to complete a set of questionnaires who were less than 16 weeks of pregnancy from seven health service centers of Shenyang. The Self-rating Anxiety Scale(SAS), the Pittsburgh Sleep Quality Index(PSQI), the Pregnancy Stress Scale(PPS), and the Perceived Social Support Scale(PSSS) were used to evaluate anxiety symptoms, sleep quality, pregnancy stress, and social support, respectively. Multiple linear regression analysis was used to explore factors associated with anxiety symptoms in pregnant women. [Results] A total of 350 questionnaires were distributed and 309 returned questionnaires were valid(88.29%). The average age of study subjects was(31.21±3.88) years old; the average anxiety symptom score was 41.99±7.45, and the anxiety symptom rate was 16.2%(50/309); the average score of sleep quality was 4.97±3.08, and 35.0% of the pregnant women had poor sleep quality; the average score of perceived social support was 71.52±11.33, and 14.2% of the subjects perceived middle and low levels of social support; the average score of pregnancy stress was 2.25±3.98, and 19.1% of the women had moderate and severe stress. Pregnancy stress and sleep quality were positively correlated with anxiety symptoms(P < 0.01), while perceived social support was positively correlated with anxiety symptoms among the women in early pregnancy(P < 0.01). According to multiple linear regression analysis, the factors associated with anxiety symptoms were sleep quality(b=0.326), perceived social support(b=-0.235), pregnancy stress(b=0.153), and exposure to noise(b=0.101).[Conclusion] The influencing factors associated with anxiety symptoms of women in early pregnancy in Shenyang are sleep quality, perceived social support, pregnancy stress, and exposure to noise, which should be addressed to improve the quality of life of the mothers.
引文
[1]施莹娟,陆峥,曹蕾蕾,等.孕期焦虑抑郁症状与人格特征、社会支持的相关性研究[J].中国妇幼保健,2018,33(18):4265-4268.
[2]于津,朱丽萍.上海市不同妊娠时期孕妇的焦虑抑郁症状调查[J].中国妇幼健康研究,2010,21(1):21-23.
[3]何永华,韦榕静,谭盛葵,等.孕妇早产的社会和行为影响因素[J].环境与职业医学,2016,33(2):147-151.
[4]张娜,高永梅,褚艳,等.孕期焦虑抑郁对早产及产后抑郁症影响的研究进展[J].中华现代护理杂志,2013,19(5):612-615.
[5]SOTO-BALBUENA C,DE LA FE RODRIGUEZ M,ESCUDEROGOMIS AI,et al.Incidence,prevalence and risk factors related to anxiety symptoms during pregnancy[J].Psicothema,2018,30(3):257-263.
[6]汪红霞,蔡传兰,崔时敏,等.妊娠期睡眠质量与焦虑症状的关联研究[J].中国妇幼健康研究,2016,27(1):28-30.
[7]贾晓敏,郝加虎,朱鹏,等.合肥地区孕妇妊娠早期心理社会应激影响因素分析[J].中国公共卫生,2016,32(3):257-261.
[8]HOU Q,LI S,JIANG C,et al.The associations between maternal lifestyles and antenatal stress and anxiety in Chinese pregnant women:A cross-sectional study[J].Sci Rep,2018,8:10771.
[9]吴尔,鲁丽容,黄华容.二胎孕妇妊娠焦虑现状及其影响因素[J].职业与健康,2018,34(5):627-629,633.
[10]夏咸权,黄石平,李芹,等.“知己健康管理”对200例孕妇营养、心理、体重指数干预调查分析[J].社区医学杂志,2010,8(3):6-7.
[11]ZUNG W W.A rating instrument for anxiety disorders[J].Psychosomatics,1971,12(6):371-379.
[12]BUYSSE D J,REYNOLDS III C F,MONK T H,et al.The pittsburgh sleep quality index:a new instrument for psychiatric practice and research[J].Psychiat Res,1989,28(2):193-213.
[13]陈彰惠,陈惠敏,黄德慧.孕妇孕期心理压力之探讨[J].高雄医志,1991,5(5):505-509.
[14]潘颖丽,高玲玲,金秀华.孕妇及其配偶心理压力的对比研究[J].广东医学,2004,25(10):1209-1210.
[15]张帆,朱树贞,邓平基.领悟社会支持量表在国内住院病人社会支持研究中的应用评价[J].护理研究,2018,32(13):2048-2052.
[16]BLUMENTHAL J A,BURG M M,BAREFOOT J,et al.Social support,type A behavior,and coronary artery disease[J].Psychosom Med,1987,49(4):331-340.
[17]毛红芳,荣荷花,王子文,等.上海市嘉定区孕产妇心理健康状况和保健需求变化调查[J].中国妇幼保健,2017,32(12):2729-2734.
[18]孟志红,刘纯艳.孕早期孕妇妊娠压力及焦虑现状的研究[J].护理研究,2011,25(14):1259-1260.
[19]THAM E K,TAN J,CHONG Y S,et al.Associations between poor subjective prenatal sleep quality and postnatal depression and anxiety symptoms[J].J Affect Disord,2016,202:91-94.
[20]周昔红,李乐之,周阳.孕妇心理压力状况及其与焦虑水平的相关性研究[J].中国现代医学杂志,2010,20(7):1079-1082.
[21]梁红.噪声对女性妊娠影响的研究进展[J].中国工业医学杂志,2018,31(1):29-31,64.
[22]MOSHKI M,CHERAVI K.Relationships among depression during pregnancy,social support and health locus of control among Iranian pregnant women[J].Int J Soc Psychiatr,2016,62(2):148-155.
[23]蔡敏.孕妇孕期焦虑抑郁情绪现状调查分析[J].医学信息,2016,29(27):249.
[24]冯秀芹.不同的社会支持对产前抑郁焦虑的影响[J].实用临床护理学电子杂志,2017,2(33):96,98.
[25]危秀青,刘桂华,钱小芳.妊娠期妇女焦虑与抑郁情况分析[J].海峡预防医学杂志,2017,23(3):30-32.
[2]于津,朱丽萍.上海市不同妊娠时期孕妇的焦虑抑郁症状调查[J].中国妇幼健康研究,2010,21(1):21-23.
[3]何永华,韦榕静,谭盛葵,等.孕妇早产的社会和行为影响因素[J].环境与职业医学,2016,33(2):147-151.
[4]张娜,高永梅,褚艳,等.孕期焦虑抑郁对早产及产后抑郁症影响的研究进展[J].中华现代护理杂志,2013,19(5):612-615.
[5]SOTO-BALBUENA C,DE LA FE RODRIGUEZ M,ESCUDEROGOMIS AI,et al.Incidence,prevalence and risk factors related to anxiety symptoms during pregnancy[J].Psicothema,2018,30(3):257-263.
[6]汪红霞,蔡传兰,崔时敏,等.妊娠期睡眠质量与焦虑症状的关联研究[J].中国妇幼健康研究,2016,27(1):28-30.
[7]贾晓敏,郝加虎,朱鹏,等.合肥地区孕妇妊娠早期心理社会应激影响因素分析[J].中国公共卫生,2016,32(3):257-261.
[8]HOU Q,LI S,JIANG C,et al.The associations between maternal lifestyles and antenatal stress and anxiety in Chinese pregnant women:A cross-sectional study[J].Sci Rep,2018,8:10771.
[9]吴尔,鲁丽容,黄华容.二胎孕妇妊娠焦虑现状及其影响因素[J].职业与健康,2018,34(5):627-629,633.
[10]夏咸权,黄石平,李芹,等.“知己健康管理”对200例孕妇营养、心理、体重指数干预调查分析[J].社区医学杂志,2010,8(3):6-7.
[11]ZUNG W W.A rating instrument for anxiety disorders[J].Psychosomatics,1971,12(6):371-379.
[12]BUYSSE D J,REYNOLDS III C F,MONK T H,et al.The pittsburgh sleep quality index:a new instrument for psychiatric practice and research[J].Psychiat Res,1989,28(2):193-213.
[13]陈彰惠,陈惠敏,黄德慧.孕妇孕期心理压力之探讨[J].高雄医志,1991,5(5):505-509.
[14]潘颖丽,高玲玲,金秀华.孕妇及其配偶心理压力的对比研究[J].广东医学,2004,25(10):1209-1210.
[15]张帆,朱树贞,邓平基.领悟社会支持量表在国内住院病人社会支持研究中的应用评价[J].护理研究,2018,32(13):2048-2052.
[16]BLUMENTHAL J A,BURG M M,BAREFOOT J,et al.Social support,type A behavior,and coronary artery disease[J].Psychosom Med,1987,49(4):331-340.
[17]毛红芳,荣荷花,王子文,等.上海市嘉定区孕产妇心理健康状况和保健需求变化调查[J].中国妇幼保健,2017,32(12):2729-2734.
[18]孟志红,刘纯艳.孕早期孕妇妊娠压力及焦虑现状的研究[J].护理研究,2011,25(14):1259-1260.
[19]THAM E K,TAN J,CHONG Y S,et al.Associations between poor subjective prenatal sleep quality and postnatal depression and anxiety symptoms[J].J Affect Disord,2016,202:91-94.
[20]周昔红,李乐之,周阳.孕妇心理压力状况及其与焦虑水平的相关性研究[J].中国现代医学杂志,2010,20(7):1079-1082.
[21]梁红.噪声对女性妊娠影响的研究进展[J].中国工业医学杂志,2018,31(1):29-31,64.
[22]MOSHKI M,CHERAVI K.Relationships among depression during pregnancy,social support and health locus of control among Iranian pregnant women[J].Int J Soc Psychiatr,2016,62(2):148-155.
[23]蔡敏.孕妇孕期焦虑抑郁情绪现状调查分析[J].医学信息,2016,29(27):249.
[24]冯秀芹.不同的社会支持对产前抑郁焦虑的影响[J].实用临床护理学电子杂志,2017,2(33):96,98.
[25]危秀青,刘桂华,钱小芳.妊娠期妇女焦虑与抑郁情况分析[J].海峡预防医学杂志,2017,23(3):30-32.