高龄不孕女性二胎生育压力与个体应对方式的中介效应

摘要

目的 探讨高龄不孕女性压力反应、压力应对方式与二胎生育压力的关系及压力应对方式的中介效应.方法 对2016年1月～2017年6月沧州中西医结合医院生殖中心门诊就诊的初诊高龄不孕女性1360例进行问卷式调查,所有患者均为计划二胎的经产妇.使用自制调查问卷对入选患者进行基本资料调查,应用压力反应、特质应对问卷以及生育压力量表对入选者进行问卷观察.采取结构方程模型来考察压力反应、压力应对方式与生育压力的关系,以及积极应对压力方式与消极应对压力方式在此类患者生育压力中的中介效应.结果 压力反应总评分与生育压力评分中各维度及其总评分呈正相关(P＜0.05);排除“父母角色需要”这一项,积极应对与生育压力各维度的评分及其总评分均呈负相关(P＜0.05);而消极应对评分与生育压力各维度及其总分则均呈正相关(P＜ 0.05).压力反应、积极应对压力与生育压力的结构方程拟合度理想,积极应对在生育压力中的中介效应显著(P＜0.05).压力反应、消极应对与生育压力的结构方程模型拟合较理想,消极应对在生育压力的中介效应不显著(P＞0.05).结论 压力反应、压力应对方式与生育压力具有相关性,高龄不孕女性二胎的生育压力在积极应对与消极应对压力方式中会产生不同的影响,且积极应对生育压力的中介效应显著.%Objective To explore the mediating effects of coping strategies in the relationship between stress reaction,coping strategies and infertility with infertility-related stress in infertile women of advanced reproductive age already have one child.Methods The study was conducted in 1360 women of advanced reproductive age who were planned second child,initially diagnosed with infertility in Reproductive Medical Center of Cangzhou Hospital of Integrated TCM-WM from January 2016 to June 2017.Self-made questionnaires was used for selected patients basic information survey.Stress reaction questionnaire,coping strategies questionnaire and fertility problem inventory were used to analyze the relationship between stress reaction,coping strategies and infertility-related stress,and the mediating effects of positive and negative coping strategies on infertility-related stress in infertile women of advanced reproductive age.Results There was a positive correlation between stress reaction questionnaire score and all dimensions of the infertility-related stress score and its total score (P ＜ 0.05).In addition to the need for parenthood,the score of positive coping strategies was negatively correlated with the score of the infertility-related stress score and its total score (P ＜ 0.05).The score of negative coping strategies was positively correlated with the score of the infertility-related stress score and its total score (P ＜ 0.05).The structural equation of stress response,positively related with pressure and fertility pressure was ideal,and the mediating effect of positive coping strategies on infertility-related stress was significant (P ＜ 0.05).The structural equation of stress response,negative response to pressure and fertility pressure was relatively ideal,but the medi ating effect of positive coping strategies on infertility-related stress was not significant (P ＞ 0.05).Conclusion The effect of stress response on positive response to pressure and negative response to pressure can affect the infertile women of advanced reproductive age already have one child.The mediating effect of positive coping strategies is significant.