早产儿母亲育儿胜任感与反刍思维的随访研究

A follow-up study about parenting sense of competence and rumination in mothers of premature infants

目的探讨早产儿母亲育儿胜任感和反刍思维的变化及其相关性。方法使用方便抽样，选取2016年4-8月在西安交通大学第一附属医院新生儿科病房住院符合纳入排除标准的早产儿母亲作为研究对象。使用中文版育儿胜任感量表和Nolen-Hoeksema反刍思维量表在早产儿出院后1、3、6和12个月分别进行测量。结果82例早产儿母亲在4个时点育儿胜任感得分分别为（62．20±11．94）、（67．32±12．28）、（68．13±12．33）、（72．56±13．39）分，差异有统计学意义（F=9．457，P〈0．01）。反刍思维得分分别为（50．52±11.26）、（46．18±10．12）、（44．36±9．85）、（42．64±9．13）分。差异有统计学意义（F=9．187，P〈0．01）。4个时点上的育儿胜任感得分与反刍思维总分、症状反刍和强迫思考间具有显著负相关（r=-0．722--0．332，P〈0．01）。多元回归分析后，反刍思维、家庭人均月收入和婚姻状况可影响早产儿母亲的育儿胜任感（t=-5．871、2．782、2．048，P〈0．01或0．05）。结论医务工作者应注重早产儿母亲的社会支持体系的调动及其负性情绪的缓解和疏导，教会其早产儿的育儿技巧和压力的积极应对方式，提高其育儿胜任感。

Objective To explore the change trend of parenting sense of competence and rumination in mothers of premature infants and their relationship. Methods Qualified participants were selected from the First Affiliated Hospital of Xi＇an Jiaotong University between April and August 2016 by convenience sampling. Chinese version of Parenting Sense of Competence Scale and Chinese version of Nolen-Hoeksema Ruminative Responses Scale were used to collect data in 1 month, 3 months, 6 months and 12 months after premature leaving hospital. Results The parenting sense of competence scores were 62.20± 11.94, 67.32± 12.28, 68.13± 12.33 and 72.56± 13.39 respectively, which had significant differences （F=9.457, P〈0.01）. The rumination scores were 50.52± 11.26, 46.18± 10.12, 44.36±9.85 and 42.64±9.13 respectively, which had significant differences （F=9.187, P〈0.01）. There were significant negative relationships between the parenting sense of competence and rumination, symptoms of rumination and forced thinking （r=- 0.722- 0.332, P〈0.01）. Rumination, income and marital status were the associated factors of parenting sense of competence after multiple linear regression analysis （t=-5.871, 2.782, 2.048, P〈0.01 or 0.05）. Conclusion Medical workers should pay attention to mobilize social support system and alleviate negative emotions of preterm mothers, teach them parenting skills and positive pressure coping style, in order to improve their parenting sense of competence.