孕产妇气质性乐观与生活满意度、妊娠压力、焦虑及抑郁的关联性分析

Relationships of dispositional optimism with life satisfaction, pregnancy stress, anxiety and depression in Chinese pregnant and parturient women

目的探讨气质性乐观与孕产妇生活满意度、妊娠压力、焦虑以及抑郁的关联性,为积极心理学等方法在孕产妇心理健康干预领域的应用提供理论依据。方法选取2015年8月至2016年10月开展的多中心中国孕产妇心理健康队列人群共1 210例为研究对象,均从怀孕13周随访至产后42天,调查和分析孕产妇一般人口学特征、气质性乐观、妊娠压力、焦虑和抑郁等相关信息。结果孕13周、17周、24周、31周、37周、产后3天和产后42天各随访时点气质性乐观者分别占77.4%、81.7%、82.6%、82.9%、85.3%、83.6%和83.0%,在整个孕期呈增长趋势,产后有所下降,差异有统计学意义(χ^(2)=30.011,P<0.01);在各随访时点,气质性乐观组生活满意度的平均得分均高于气质性悲观组,妊娠压力、焦虑和抑郁的平均得分均低于气质性悲观组,差异均有统计学意义(t值介于-10.299~17.078之间,P<0.05);各随访时点的乐观维度与生活满意度均存在正相关,与妊娠压力、焦虑和抑郁存在负相关,而悲观维度与妊娠压力、焦虑和抑郁存在正相关,与生活满意度存在负相关(P<0.01)。结论气质性乐观能够直接地影响孕产妇的抑郁情绪、压力程度及生活满意度,是孕产妇心理健康的预测变量和保护因素,建议进一步探索提升孕产妇乐观气质的保健技术方法。

Objective To explore relationships of dispositional optimism of pregnant and parturient women with their life satisfaction, pregnancy stress, anxiety and depression, so as to provide theoretical basis for applying positive psychology in the field of maternal mental health intervention.Methods 1 210 pregnant and parturient women from National Prospective Cohort Study on the Mental Health of Chinese Pregnant Women(NSMCP) over a period from August 2015 to October 2016 were selected as resarch subjects.The pregnant and parturient women were followed up from the 13 th weeks of gestation to the 42 th days after delivery.General demographic characteristics, dispositional optimism, pregnancy stress, anxiety and depression of the pregnant and parturient women in the cohort were surveyed and analyzed statistically by using the life orientation test-revised(LOT-R),satisfaction with life scale(SWLS),pregnancy stress rating scale(PSRS),self-rating anxiety scale(SAS) and Edinburgh postnatal depression scale(EPDS).Results At follow-up time points 13,17,24,31 and 37 weeks of gestation and 3 days and 42 days after delivery, the dispositional optimists accounted for 77.4%,81.7%,82.6%,82.9%,85.3%,83.6% and 83.0% respectively, which showed an increasing trend during the whole pregnancy, while a descending trend after delivery, and the difference was statistically significant(χ^(2)=30.011,P<0.01).At 7 follow-up time points, the average score in life satisfaction of the pregnant and parturient women in the dispositional optimism group was higher than that of the pregnant and parturient women in the dispositional pessimism group, while the average scores in pregnancy stress, anxiety and depression of the pregnant and parturient women were lower than those in the dispositional pessimism group, and the differences were statistically significant(t=-10.299~17.078,all P<0.05).The optimistic dimension at each follow-up time point was positively correlated with life satisfaction, and negatively correlated with pregnancy stress, anxiety and depression, while pessimistic dimension was positively correlated with pregnancy stress, anxiety, and depression, and negatively correlated with life satisfaction(all P<0.01).Conclusion Dispositional optimism can directly affect depression, stress level and life satisfaction of the pregnant and parturient women.It is a predictor and protective factor for mental health of the pregnant and parturient women.It is recommended to further explore health care techniques to improve dispositional optimism of the pregnant and parturient women.