不孕不育女性生育压力与抑郁的关系:有调节的中介模型

Relationship between infertility-related stress and depression of infertility women:a moderated mediation model

目的探讨不孕不育女性生育压力和抑郁的关系,以及应对方式和心理弹性在其中发挥的作用。方法采用便利抽样法于2020年4月至2021年4月,对苏州大学附属第一医院生殖医学中心进行辅助生殖技术治疗的230名不孕不育女性进行横断面调查,采用生育问题量表、简易应对方式量表、心理弹性量表简版以及患者健康问卷对不孕不育女性的生育压力、应对方式、心理弹性、抑郁情况进行调查,并对其进行相关性分析和效应分析。结果最终回收问卷219份,有效回收率为95.2%(219/230)。不孕不育女性生育问题量表总分为(136.21±27.38)分,简易应对方式量表总分为(34.26±7.66)分,心理弹性量表简版总分为(27.50±6.78)分,患者健康问卷总分为(4.26±3.83)分。相关性分析显示,不孕不育女性生育压力与消极应对、抑郁呈正相关(r=0.20、0.26,均P<0.01),消极应对与抑郁呈正相关(r=0.23,P<0.01)。效应分析显示,消极应对在不孕不育女性生育压力与抑郁之间起部分中介作用,中介效应值为0.05,占总效应的15.63%,心理弹性对中介作用的后半段路径起调节作用(β=-0.137,t=-2.11,P<0.05)。结论不孕不育女性生育压力可正向预测抑郁情绪,消极应对在生育压力与抑郁之间起中介作用且心理弹性调节了消极应对对抑郁的影响。

Objective To explore the relationship of infertility-related stress and depression of infertility women,and the effect of coping style and resilience in it.Methods A cross sectional study was conducted in 230 infertility women who treated with Assisted Reproductive Technology in Reproductive Medical Center of the First Affiliated Hospital of Soochow University using convenience sampling method from April 2020 to April 2021 with self-made general information questionnaire,Fertility Problem Inventory,Simplified Coping Style Questionnaire,10-item Connor-Davidson Resilience Scale and Patients'Health Questionnaire Depression Scale-9 item.And correlation and effect analysis was conducted.Results Two hundred and nineteen questionnaires were finally collected,the effective recovery rate was 95.2%(219/230).The score of Fertility Problem Inventory was(136.21±27.38)points,the score of Simplified Coping Style Questionnaire was(34.26±7.66)points,the score of 10-item Connor-Davidson Resilience Scale was(27.50±6.78)points,the score of Patients'Health Questionnaire Depression Scale-9 item was(4.26±3.83)points.Correlation analysis results showed that infertility-related stress of infertility women was positively correlated with negative coping(r=0.20,P<0.01)and depression(r=0.26,P<0.01),negative coping was positively correlated with depression(r=0.23,P<0.01).Effect analysis results showed that negative coping had a partial mediating effect between infertility-related stress and depression,and the mediating effect size was 0.05,accounting for 15.63%of the total effects.Resilience moderated the second half path of the mediation relationship(β=-0.137,t=-2.11,P<0.05).Conclusions The infertility-related stress is a positive predictor of depression.Negative coping has a mediating effect between infertility-related stress and depression,and resilience moderates the effect of negative coping on depression.