Yang Irene, Hall Lynne A, Ashford Kristin, Paul Sudeshna, Polivka Barbara, Ridner S Lee
Irene Yang, PhD, RN, is Postdoctoral Fellow, Emory University School of Nursing, Atlanta, Georgia. Lynne A. Hall, DrPH, RN, is Professor and Associate Dean for Research, University of Louisville School of Nursing, Kentucky. Kristin Ashford, PhD, APRN, is Associate Professor, University of Kentucky College of Nursing, Lexington. Sudeshna Paul, PhD, is Assistant Research Professor, Emory University School of Nursing, Atlanta, Georgia. Barbara Polivka, PhD, RN, is Professor and Shirley B. Powers Chair in Nursing, University of Louisville School of Nursing, Kentucky. S. Lee Ridner, PhD, FNP-BC, is Associate Dean for Graduate Programs, University of Louisville School of Nursing, Kentucky.
Nurs Res. 2017 Jan/Feb;66(1):2-11. doi: 10.1097/NNR.0000000000000191.
Low-income, unemployed women with low levels of education are more likely to smoke during pregnancy compared to their higher-income, employed, and well-educated counterparts. The reserve capacity model (RCM) offers a theoretical framework to explain how psychosocial factors may serve as pathways connecting socioeconomic status (SES) to health behaviors. Research supports the link between prenatal smoking and several psychosocial variables such as chronic stressors, depressive symptoms, and social support. How these variables interrelate to explain the predominance of prenatal smoking in lower socioeconomic groups of pregnant women has not been fully elucidated.
The aim of this study was to test the RCM to evaluate the roles of early pregnancy levels of chronic stress, quality of the primary intimate relationship, and depressive symptoms in explaining the relationship between SES and persistent prenatal smoking.
A secondary analysis of data from 370 pregnant nonsmokers, spontaneous quitters, and persistent prenatal smokers was conducted. On the basis of the RCM, chronic stressors, depressive symptoms, and the quality of the primary intimate relationship were evaluated as potential mediating variables linking SES with persistent prenatal smoking using path analysis.
Path analyses indicated that a simple model with all three psychosocial variables as mediators of the relationship between SES and persistent prenatal smoking provided the best fit.
Findings indicated that chronic stressors, depressive symptoms, and the quality of the primary intimate relationship play important roles in the pathway from SES to prenatal smoking status. This knowledge can assist in the development of prevention and intervention strategies to target these variables and ultimately reduce prenatal smoking.
与高收入、有工作且受过良好教育的女性相比，低收入、失业且受教育程度低的女性在孕期吸烟的可能性更大。储备能力模型（RCM）提供了一个理论框架，用以解释心理社会因素如何作为连接社会经济地位（SES）与健康行为的途径。研究支持产前吸烟与多种心理社会变量之间的联系，如慢性应激源、抑郁症状和社会支持。这些变量如何相互关联以解释低收入社会经济群体中孕妇产前吸烟的普遍性尚未完全阐明。
本研究的目的是检验储备能力模型，以评估孕早期慢性应激水平、主要亲密关系质量和抑郁症状在解释社会经济地位与持续产前吸烟之间关系中的作用。
对370名怀孕的非吸烟者、自发戒烟者和持续产前吸烟者的数据进行二次分析。基于储备能力模型，使用路径分析将慢性应激源、抑郁症状和主要亲密关系质量评估为连接社会经济地位与持续产前吸烟的潜在中介变量。
路径分析表明，一个将所有三个心理社会变量作为社会经济地位与持续产前吸烟之间关系中介的简单模型拟合度最佳。
研究结果表明，慢性应激源、抑郁症状和主要亲密关系质量在从社会经济地位到产前吸烟状况的路径中起重要作用。这些知识有助于制定针对这些变量的预防和干预策略，并最终减少产前吸烟。
