中国孕妇心理韧性情况及其影响因素分析

Mental resilience of pregnant women and its influencing factors in China

目的了解中国孕妇的心理韧性情况,探讨孕妇心理韧性的影响因素及其与生活满意度、气质性乐观、妊娠压力、焦虑、抑郁和睡眠质量的关系。方法选取2015年8月至2016年10月在山西省妇幼保健院、吉林省妇幼保健院、广东省珠海市妇幼保健院、广东省深圳市妇幼保健院、北京市海淀区妇幼保健院建档并进行产检的1 141人孕妇作为研究对象,使用心理韧性量表简化版(CD-RISC-10)对孕妇心理韧性情况进行调查,并按照中位数将其分为高心理韧性组(>37分,n=566)和低心理韧性组(≤37分,n=575),分析其影响因素。结果与低心理韧性组相比,高心理韧性组学历较高、婚姻状况评价较高、孕期进行锻炼、家庭年收入较低、社会支持(丈夫支持、父母支持、公婆支持)力度均较强,差异有统计学意义(χ^(2)值分别为8.419、19.118、4.105、7.973、7.950、6.129、7.973,P<0.05);高心理韧性组的生活满意度和气质性乐观得分显著高于低心理韧性组,而妊娠压力、焦虑、抑郁和睡眠质量量表的得分均显著低于低心理韧性组,差异均有统计学意义(t值分别为-3.473、6.135、4.528、3.745、5.313、3.276,P<0.05);多因素Logistic回归分析显示学历较高、家庭年收入较低、气质型乐观量表得分较高是影响孕妇心理韧性的促进因素,其OR值及95%CI分别为1.786(1.211~2.635)、0.510(0.359~0.724)、1.116(1.059~1.176),P<0.05。结论我国孕妇的心理韧性水平受到学历、家庭收入、气质型乐观状态等综合影响,应在孕产期保健工作过程中进一步关注孕妇的心理韧性情况,及时干预,以期改善其心理健康状况和妊娠结局。

Objective To investigate mental resilience of pregnant women in China, and to explore influencing factors of maternal resilience and its relationships with life satisfaction, dispositional optimism, pregnancy stress, anxiety, depression and sleep quality.Methods A total of 1 141 pregnant women who were registered and received prenatal examination in Shanxi Provincial Maternal and Child Health Hospital, Jilin Provincial Maternal and Child Health Hospital, Zhuhai Municipal Maternal and Child Health Hospital and Shenzhen Municipal Maternal and Child Health Hospital of Guangdong Province, Beijing Haidian District Maternal and Child Health Hospital from 2015 to 2016 were selected as study subjects.The psychological toughness of the pregnant women was investigated by using the simplified version of Connor-Davidson resilience scale(CD-RISC-10).According to the median of the toughness, the pregnant women were divided into high psychological toughness group(>37 points, n=566) and low psychological toughness group(≤37 points, n=575),and the influencing factors were analyzed.Results Compared with the low resilience group, the pregnant women in the high resilience group had higher educational background, higher marital status evaluation, higher rate of exercise during pregnancy, lower annual family income, and stronger social support from husband, parents and parents-in-law, and the differences were statistically significant(χ^(2)=8.419,19.118,4.105,7.973,7.950,6.129 and 7.973 respectively, all P<0.05).The scores of the pregnant women in life satisfaction and dispositional optimism in the high resilience group were significantly higher than those in the low resilience group, while the scores of the pregnant women in pregnancy stress, anxiety, depression and sleep quality were significantly lower than those in the low resilience group, and the differences were statistical significant(t=-3.473,6.135,4.528,3.745,5.313 and 3.276 respectively, P<0.05).Multivariate logistic regression analysis showed that high educational background, low annual family income, and high scores in dispositional optimism were all promoting factors affecting maternal resilience, the ORs(95%CI) were 1.786(1.211~2.635),0.510(0.359~0.724) and 1.116(1.059~1.176),respectively, all P<0.05.Conclusion The mental toughness of pregnant women in China is comprehensively affected by educational background, family income and dispositional optimism, etc.Therefore, more attention should be paid to mental toughness of the pregnant women in health care during pregnancy and postpartum, and timely intervention should be taken to improve their mental health status and pregnancy outcome.