胎儿畸形诊断后的堕胎：个体堕胎耻辱感量表德语版的心理测量学特性。
Abortion after diagnosis of fetal anomaly: Psychometric properties of a German version of the individual level abortion stigma scale.
机构信息
Department of Psychosomatic Medicine, University of Leipzig, Leipzig, Germany.
Department of Obstetrics, University of Leipzig, Leipzig, Germany.
出版信息
PLoS One. 2018 Jun 12;13(6):e0197986. doi: 10.1371/journal.pone.0197986. eCollection 2018.
BACKGROUND
Diagnosis of fetal anomaly is a significant life event and social stigma can negatively impact on the well-being of women opting for an abortion. This study investigated the psychometric properties of a measure of stigma among women who had had an abortion after diagnosis of fetal anomaly in a German setting.
METHODS
The Individual Level Abortion Stigma (ILAS) scale was translated into German. Psychometric properties of the ILAS scale were examined among 130 women with a history of an abortion after diagnosis of fetal anomaly. Individual and situational factors associated with stigma in the context of an abortion after diagnosis of fetal anomaly were explored.
RESULTS
Factor analysis suggested a four-dimensional structure of the German version of the Individual Level Abortion Stigma scale (Cronbach's α, .83-.91), corresponding to the subscales of the original scale. Test-retest reliability was acceptable for the worries about judgment subscale, the self-judgment subscale, and the community condemnation subscale, but less convincing for the isolation subscale. Associations between the subscales and measures of depression, self-esteem and secrecy were found in directions consistent with theory. Women who did not perceive their fetus to have a low survival chance and women whose fetus was at higher gestational age reported higher levels of stigma, whereas higher perceived partner support was associated with lower levels of stigma.
LIMITATION
Generalizability of study results was limited, as participants were recruited from one clinic in Germany and the study had a response rate of 46.5%.
CONCLUSIONS
The ILAS subscales are largely reliable and valid measures to assess stigma among women who have had an abortion after diagnosis of fetal anomaly. Suggestions for improving the assessment of stigma experienced in this population are outlined. The scales can be useful in research aiming at investigating psychological outcomes of abortion after diagnosis of fetal anomaly and improving care structures.
背景
胎儿异常的诊断是一个重大的生活事件，社会耻辱感可能会对选择堕胎的女性的幸福感产生负面影响。本研究旨在调查德国环境中，在胎儿异常诊断后选择堕胎的女性中，耻辱感的衡量标准的心理测量特性。
方法
个体层面堕胎耻辱感量表（ILAS）被译为德文。在 130 名有过胎儿异常诊断后堕胎史的女性中，对 ILAS 量表的心理测量特性进行了研究。探讨了与胎儿异常诊断后堕胎相关的个体和情境因素与耻辱感的关系。
结果
因子分析表明，德国版个体层面堕胎耻辱感量表（ILAS）具有四个维度结构（Cronbach's α，0.83-0.91），与原始量表的子量表相对应。担忧判断子量表、自我判断子量表和社区谴责子量表的重测信度是可以接受的，但隔离子量表的重测信度不太令人信服。子量表与抑郁、自尊和保密性测量之间的关联与理论一致。那些认为自己胎儿存活机会低的女性和那些胎儿处于更高胎龄的女性报告的耻辱感水平更高，而感知到的伴侣支持水平越高，耻辱感水平越低。
局限性
研究结果的普遍性有限，因为参与者是从德国的一家诊所招募的，研究的回应率为 46.5%。
结论
ILAS 子量表是评估胎儿异常诊断后堕胎女性耻辱感的可靠且有效的测量工具。概述了改善该人群中经历的耻辱感评估的建议。这些量表在研究旨在调查胎儿异常诊断后堕胎的心理后果和改善护理结构方面可能很有用。
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