School of Nursing The University of Hong Kong.
J Adv Nurs. 2012 Dec;68(12):2633-45. doi: 10.1111/j.1365-2648.2012.05962.x. Epub 2012 Feb 23.
To report a study of the relations of prenatal psychosocial adaptation, social support, demographic and obstetric characteristics, uncertainty, information-seeking behaviour, motherhood normalization, self-efficacy, and commitment to pregnancy.
Prenatal psychosocial assessment is recommended to identify psychosocial risk factors early to prevent psychiatric morbidities of mothers and children. However, knowledge on psychosocial adaptation and its explanatory variables is inconclusive.
This study was non-experimental, with a cross-sectional, correlational, prospective design.
The study investigated Hong Kong Chinese women during late pregnancy. Convenience sampling methods were used, with 550 women recruited from the low-risk clinics of three public hospitals. Data was collected between January-April 2007. A self-reported questionnaire was used, consisting of a number of measurements derived from an integrated framework of the Life Transition Theory and Theory of Uncertainty in Illness. Explanatory variables of psychosocial adaptation were identified using a structural equation modelling programme.
The four explanatory variables of the psychosocial adaptation were social support, uncertainty, self-efficacy, and commitment to pregnancy. In the established model, which had good fit indices, greater psychosocial adaptation was associated with higher social support, higher self-efficacy, higher commitment to pregnancy, and lower uncertainty.
The findings give clinicians and midwives guidance in the aspects to focus on when providing psychosocial assessment in routine prenatal screening. Since there are insufficient reliable screening tools to assist that assessment, midwives should receive adequate training, and effective screening instruments have to be identified. The explanatory role of uncertainty found in this study should encourage inquiries into the relationship between uncertainty and psychosocial adaptation in pregnancy.
报告一项关于产前心理社会适应、社会支持、人口统计学和产科特征、不确定性、信息寻求行为、母亲身份正常化、自我效能感和对妊娠的承诺之间关系的研究。
建议进行产前心理社会评估，以早期识别心理社会危险因素，预防母婴精神病理学。然而，关于心理社会适应及其解释变量的知识尚无定论。
本研究为非实验性、横断面、相关性、前瞻性设计。
本研究调查了香港的中国孕妇。采用便利抽样方法，从三家公立医院的低风险诊所招募了 550 名妇女。数据收集于 2007 年 1 月至 4 月期间。使用自我报告问卷进行调查，该问卷由生命转变理论和疾病不确定性理论综合框架衍生的多项测量组成。使用结构方程建模程序确定心理社会适应的解释变量。
心理社会适应的四个解释变量是社会支持、不确定性、自我效能感和对妊娠的承诺。在具有良好拟合指数的既定模型中，更高的心理社会适应与更高的社会支持、更高的自我效能感、更高的对妊娠的承诺以及更低的不确定性相关。
这些发现为临床医生和助产士在常规产前筛查中提供心理社会评估方面提供了指导。由于缺乏可靠的可靠筛查工具来协助评估，助产士应接受充分的培训，并确定有效的筛查工具。本研究中发现的不确定性的解释作用应鼓励探究不确定性与妊娠期间心理社会适应之间的关系。
