复发性流产患者感知压力、心理困扰与生育生命质量问的关系研究

Research on relationship among perceived stress, psychological distress and fertility quality of life of patients with recurrent spontaneous abortion

目的调查复发性流产患者生育生命质量现状，分析感知压力、心理困扰对复发性流产患者生育生命质量的影响，并探讨心理困扰在感知压力和生命质量间的中介效应。方法采用便利抽样法，使用感知压力量表、医院焦虑抑郁量表及生育生命质量量表对山东大学附属生殖医院复发性流产门诊就诊的213例患者进行问卷调查。结果复发性流产患者生育生命质量总得分为（62．02±14．41）分，4个维度得分依次为：情绪质量（60．01±19．51）分，身心质量（64．28±21．65）分，夫妻关系（66．57±14．53）分，社会关系（67．57±17．35）分。感知压力与焦虑、抑郁呈正相关（r=0．544、0．629，均P〈0．01）；与生育生命质量各维度呈负相关（r=-0．522～-0．285，均P〈0．01）；焦虑、抑郁与生育生命质量各维度呈负相关（r=-0．541～-0．250，均P〈0．01）。运用Bootstrap检验方法显示：间接效应的95％CI为-0．74～-0．14，P=0．003。结论感知压力和心理困扰是影响复发性流产患者生育生命质量的相关因素，心理困扰可以中介感知压力与生育生命质量的关系。医护人员不仅要关注复发性流产患者的压力管理，同时应注重心理健康的干预，以此来改善患者的生育生命质量。

Objective To investigate the Fertility Quality of Life （FertiQoL） among patients with recurrent spontaneous abortion, analyze the relationships among perceived stress, psychological distress and FertiQoL, and further examine the mediating effect of psychological distress on relationships between perceived stress and FertiQoL. Methods This survey included 213 patients with recurrent spontaneous abortion from Center for Reproductive Medicine of Shandong University, which were investigated by questionnaires including FertiQoL, the Perceived Stress Scale, and the Hospital Anxiety Depression Scale. Results The total Core-FertiQoL score was （62.02±14.41） points, which included four subscales as emotional, mind/body, relational and social and scored （60.01±19.51）, （64.28 ±21.65）, （66.57±14.53）, （67.57 ±17.35） points, respectively. Perceived stress was positively associated with anxiety, depression （r = 0.544, 0.629, P〈0.01） and were negatively associated with FertiQoL and its four subscales （r=- 0.522～-0.285, P 〈0.01）, and anxiety, depression was negatively associated with FertiQoL and its four subscales （r=-0.541～ -0.250, P〈0.01）. Furthermore, Bootstrap-generated 95%CI was -0.74～-0.14, P= 0.003 and did not include zero, which indicated that psychological distress significantly mediated the relationship between perceived stress and FertiQoL. Conclusions Perceived stress and psychological distress could affect FertiQoL of patients with recurrent spontaneous abortion and psychological distress could mediate the relationship between perceived stress and FertiQoL. Medical staff should pay attention to not only the stress management of patients with recurrent spontaneous abortion, but also the intervention of psychological distress to improve the FertiQoL.