University of Michigan School of Nursing, Ann Arbor, MI, USA.
J Adv Nurs. 2013 Jul;69(7):1562-73. doi: 10.1111/jan.12015. Epub 2012 Sep 26.
To test alternatives to the current research and clinical practice of assuming that married or partnered status is a proxy for positive social support.
Having a partner is assumed to relate to better health status via the intermediary process of social support. However, women's health research indicates that having a partner is not always associated with positive social support.
An exploratory post hoc analysis focused on posttraumatic stress and childbearing was conducted using a large perinatal database from 2005-2009.
To operationalize partner relationship, four variables were analysed: partner ('yes' or 'no'), intimate partner violence ('yes' or 'no'), the combination of those two factors, and the woman's appraisal of the quality of her partner relationship via a single item. Construct validity of these four alternative variables was assessed in relation to appraisal of the partner's social support in labour and the postpartum using linear regression standardized betas and adjusted R-squares. Predictive validity was assessed using unadjusted and adjusted linear regression modelling.
Four groups were compared. Married, abused women differed most from married, not abused women in relation to the social support, and depression outcomes used for validity checks. The variable representing the women's appraisals of their partner relationships accounts for the most variance in predicting depression scores.
Our results support the validity of operationalizing the impact of the partner relationship on outcomes using a combination of partnered status and abuse status or using a subjective rating of quality of the partner relationship.
检验替代当前研究和临床实践的方法,即假设已婚或有伴侣状态是积极社会支持的代表。
人们普遍认为,有伴侣可以通过社会支持的中介过程与更好的健康状况相关。然而,女性健康研究表明,有伴侣并不总是与积极的社会支持相关。
利用 2005-2009 年期间的一个大型围产期数据库,进行了一项探索性事后分析,重点关注创伤后应激和生育问题。
为了操作化伴侣关系,分析了四个变量:伴侣(“是”或“否”)、亲密伴侣暴力(“是”或“否”)、这两个因素的组合,以及女性通过单项评估对伴侣关系质量的看法。使用线性回归标准化贝塔系数和调整后的 R 平方评估这四个替代变量的结构有效性,以及与分娩和产后阶段伴侣社会支持的评估相关的有效性。使用未调整和调整后的线性回归模型评估预测有效性。
比较了四个组。在与社会支持和抑郁结局相关的有效性检查中,已婚、受虐妇女与已婚、未受虐妇女的差异最大。代表女性对伴侣关系看法的变量在预测抑郁评分方面解释了最大的方差。
我们的结果支持使用伴侣关系的结合(已婚和受虐状态)或使用伴侣关系质量的主观评估来操作化伴侣关系对结局的影响的有效性。