Andrews F M, Abbey A, Halman L J
Institute for Social Research, University of Michigan, Ann Arbor 48106-1248.
Fertil Steril. 1992 Jun;57(6):1247-53. doi: 10.1016/s0015-0282(16)55082-1.
To compare the dynamics of fertility-problem stress experienced by wives and husbands in infertile couples with the dynamics of stress from other sources experienced by members of couples presumed to be fertile.
Relationships of stress to four marriage factors and four aspects of life quality (subjective well-being) are examined within a causal modeling framework using data from structured interviews.
Face-to-face interviews were conducted in study participants' homes.
Wives and husbands from 157 couples with primary infertility and from 82 presumed-fertile couples were studied.
Final outcome measures were four multi-item scales assessing life quality with regard to the marriage, own self-efficacy, own health and appearance, and life as a whole. Intervening outcome scales measured four marriage factors: marital conflict, sexual self-esteem, sexual dissatisfaction, and frequency of intercourse.
Higher levels of stress, regardless of whether that stress was from attempting to solve a fertility problem or another problem, were related to reduced marital functioning and decreased life quality. For husbands, the strengths of the linkages did not depend on the source of the stress. For wives, however, the causal model suggested that fertility-problem stress had stronger negative impacts on sense of sexual identity and self-efficacy than did stress from other problems (P less than 0.05). Stress from any source had more impact on the lives of wives than of husbands, more impact on satisfaction with self and general well-being than on satisfaction with the marriage or health, and affected life quality mostly indirectly through its impacts on the marriage factors.
比较不孕夫妇中妻子和丈夫所经历的生育问题压力动态变化，与假定可育夫妇成员所经历的其他来源压力动态变化。
使用结构化访谈数据，在因果建模框架内研究压力与四个婚姻因素和生活质量（主观幸福感）四个方面的关系。
在研究参与者家中进行面对面访谈。
对157对原发性不孕夫妇和82对假定可育夫妇的妻子和丈夫进行了研究。
最终结局指标是四个多项目量表，分别评估婚姻、自身自我效能感、自身健康和外貌以及整体生活方面的生活质量。中间结局量表测量四个婚姻因素：婚姻冲突、性自尊、性不满和性交频率。
无论压力是来自试图解决生育问题还是其他问题，较高水平的压力都与婚姻功能下降和生活质量降低有关。对丈夫而言，联系的强度不取决于压力来源。然而，对妻子来说，因果模型表明生育问题压力对性认同和自我效能感的负面影响比对其他问题的压力更强（P小于0.05）。任何来源的压力对妻子生活的影响都比对丈夫的影响更大，对自我满意度和总体幸福感的影响比对婚姻或健康满意度的影响更大，并且主要通过对婚姻因素的影响间接影响生活质量。
