高龄产妇的知觉压力在反刍思维与产后抑郁间的中介效应

Mediating effect of perceived stress between rumination and postpartum depression in elderly postpartum women

目的探讨高龄产妇的知觉压力、反刍思维与产后抑郁之间的关系,为医护人员采取干预措施提供参考依据。方法选取2023年1~5月在苏州市第九人民医院产科产检并分娩的126例高龄产妇作为调查对象。于产后6周向其发放一般资料表、知觉压力量表、反刍思维量表、产后抑郁量表。采用Pearson相关法分析知觉压力、反刍思维与产后抑郁三者关系;采用Amos 23.0软件分析高龄产妇知觉压力在反刍思维与产后抑郁间的中介作用并建立路径关系模型。结果高龄产妇的知觉压力量表得分为(28.17±5.93)分、反刍思维量表得分为(39.49±8.74)分、产后抑郁量表得分为(9.34±2.16)分。不同家庭关系的高龄产妇知觉压力得分、反刍思维得分、产后抑郁得分的比较,差异均有统计学意义(P<0.05);不同家庭月收入的高龄产妇知觉压力得分、产后抑郁得分的比较,差异均有统计学意义(P<0.05);新生儿出生后母婴分离的高龄产妇知觉压力得分、反刍思维得分、产后抑郁得分均高于未发生母婴分离者,差异均有统计学意义(P<0.05)。相关性分析发现,高龄产妇的知觉压力与反刍思维、产后抑郁均呈正相关(P<0.05);高龄产妇的反刍思维与产后抑郁呈正相关(P<0.05)。中介效应分析发现,高龄产妇知觉压力对反刍思维的直接作用值为0.482,对产后抑郁的直接作用值为0.407;反刍思维对产后抑郁的直接作用值为0.513。知觉压力通过反刍思维对产后抑郁的间接作用值为0.247,占总效应的37.78%。结论高龄产妇的知觉压力在反刍思维与产后抑郁间起部分中介作用,缓解产妇的知觉压力,有利于降低反刍思维,减少产后抑郁发生。

Objective To explore the relationship between perceived stress,rumination and postpartum depression in women with advanced maternal age,provide a clinical reference which could inform medical practitioners on organizing intervention.Methods Subjects containing 126 women with advanced maternal age were sampled from pregnant patients examined and delivered in the Suzhou Ninth People's Hospital from January to May,2023.General information questionnaire,perceived stress scale,rumination scale and postpartum depression scale were completed at 6 weeks postpartum.The relationship between perceived stress,rumination and postpartum depression were conducted by Pearson correlation analysis.Using Amos 23.O software to analyze the mediating effect of perceived stress on rumination and postpartum depression in women with advanced maternal age,and establishing a pathway relationship model.Results The subjects scored(28.17±5.93)in perceived stress scale,(39.49±8.74)in rumination scale,and(9.34±2.16)in postpartum depression scale.Differences in the perceived stress,rumination,and postpartum depression scores among patients with different family relationships were statistically significant(P<0.05).Statistically significant differences were also in perceived stress and postpartum depression scores of patients with different monthly household income(P<0.05).The scores of perceived stress,rumination,and postpartum depression in surveyed women with maternal infant separation after birth were significantly higher than those without maternal infant separation(P<0.05).Correlation analysis found that perceived stress of women in advanced maternal age was positively correlated with rumination and postpartum depression(P<0.05),and rumination was positively correlated with postpartum depression(P<0.05).Affer mediation effect analysis,the direct effect of perceived stress on rumination was 0.482,and the direct effect on postpartum depression was 0.407;The direct effect value of rumination thinking on postpartum depression was 0.513.The indirect efect of perceived stress on postpartum depression through rumination was 0.247,accounting for 37.78% of the total effect.Conclusion The perceived stress of elderly postpartum women plays a partial mediating role on the relationship between rumination and postpartum depression.Relieving the perceived stress of postpartum women is beneficial for reducing rumination and the occurrence of postpartum depression.