Lechner L, Bolman C, van Dalen A
Faculty of Psychology, Netherlands Open University, Heerlen, The Netherlands.
Hum Reprod. 2007 Jan;22(1):288-94. doi: 10.1093/humrep/del327. Epub 2006 Aug 18.
Around 4% of all couples remain involuntarily childless. These people often experience insufficient social support, which further aggravates the distress symptoms such as physical health problems, anxiety, depression and complicated grief. This study investigates the association of coping style and the degree of satisfaction regarding social support from primary support groups with distress symptoms of involuntarily childless individuals.
Subjects in this cross-sectional study were people who wanted to have children with their partner but were unable to conceive and had acknowledged their involuntary childlessness. The sample consisted of 116 persons (response 88%) with an average age of 39 years (SD = 6.0), with 75% women. The sample group completed a questionnaire consisting of passive and active coping styles from the Utrecht Coping List (UCL), the discrepancy variant of the Social Support List (SSL-D), the short version of the Questionnaire on Experienced Health Complaints (VOEG-21), the Hospital Anxiety and Depression Scale (HADS) and the Inventory of Complicated Grief-Revised (ICG-R), adapted for this study.
Women especially experienced more health complaints, more anxiety and depression symptoms and more complicated grief than the general population. Regression analysis shows that when controlled for sex and the duration of involuntary childlessness, the concepts passive coping style and dissatisfaction with social support were positively associated with health complaints, depression, anxiety and complicated grief. The concept active coping style was negatively associated with depression, anxiety and complicated grief. Explained variance of the different distress symptoms varied from 30 to 65%. A moderating association of perceived social support is only found between a passive coping style and health complaints.
Psychosocial interventions should be continued after the childlessness has become definite. By teaching couples how to cope actively with their childlessness and how to ask for support, the negative consequences of their childlessness may be decreased.
约4%的夫妇非自愿不育。这些人往往社会支持不足，这进一步加重了诸如身体健康问题、焦虑、抑郁和复杂悲伤等痛苦症状。本研究调查了应对方式以及来自主要支持群体的社会支持满意度与非自愿不育个体痛苦症状之间的关联。
本横断面研究的受试者为那些想与伴侣生育但无法受孕且已承认非自愿不育的人。样本由116人组成（应答率88%），平均年龄39岁（标准差 = 6.0），其中75%为女性。样本组完成了一份问卷，该问卷包括来自乌得勒支应对清单（UCL）的被动和主动应对方式、社会支持清单差异版（SSL-D）、经验性健康投诉问卷简版（VOEG-21）、医院焦虑抑郁量表（HADS）以及为本研究改编的复杂悲伤修订量表（ICG-R）。
与一般人群相比，女性尤其经历了更多的健康投诉、更多的焦虑和抑郁症状以及更复杂的悲伤。回归分析表明，在控制性别和非自愿不育持续时间后，被动应对方式和对社会支持的不满与健康投诉、抑郁、焦虑和复杂悲伤呈正相关。主动应对方式与抑郁、焦虑和复杂悲伤呈负相关。不同痛苦症状的解释方差在30%至65%之间。仅在被动应对方式和健康投诉之间发现了感知社会支持的调节关联。
在不育已确定后，应继续进行心理社会干预。通过教导夫妇如何积极应对不育以及如何寻求支持，不育的负面后果可能会减少。
