Department of Psychology, Institute of Population Health, Faculty of Health and Life Sciences, University of Liverpool, Liverpool, UK.
School of Psychology, Faculty of Health, Liverpool John Moore's University, Liverpool, UK.
Arch Womens Ment Health. 2022 Jun;25(3):655-665. doi: 10.1007/s00737-022-01233-9. Epub 2022 Apr 30.
The Postpartum Specific Anxiety Scale [PSAS] was developed and validated as a research tool with a four-factor structure; with predictive validity corroborated in studies examining infant-feeding and maternal bonding outcomes. The PSAS has not been examined in relation to birth experiences. We aimed to confirm the PSAS four-factor structure and examine these domains of anxiety in relation to subjective and objective birth experiences. Postpartum mothers (≤ 12-months; N = 500) completed the PSAS alongside measures of subjective birth satisfaction and objective obstetric interventions/complications. Confirmatory factor analyses [CFA] tested eight models, theoretically derived from the preceding exploratory work. Structural equation modelling [SEM] tested associations between each PSAS factor and birth experience variables in the best-fitting model. An identical 51-item four-factor model fits the data well. SEM analyses revealed associations between lower perceptions of quality of intrapartum care and increased maternal competence and attachment anxieties, practical infant care anxieties, and infant safety and welfare anxieties. High subjective stress and negative emotional response to labour were associated with increased psychosocial adjustment to motherhood anxieties. Specific associations were found between neonatal care unit admission and practical infant care anxieties; and infant asphyxia and infant safety and welfare anxieties. Findings confirm construct and convergent validity of the four-factor PSAS and its use in measuring postpartum anxiety. Unique associations were also identified, indicating specific subjective and objective experiences occurring during birth may elicit a differential anxiety response, in that they are related to specific forms of postpartum anxiety which occur during the first postpartum year.
产后特定焦虑量表（PSAS）是作为一种研究工具开发和验证的，具有四因素结构；在研究婴儿喂养和母婴联系结果的研究中，验证了其预测效度。PSAS 尚未在与分娩经历有关的研究中进行检查。我们旨在确认 PSAS 的四因素结构，并研究这些焦虑领域与主观和客观分娩经历的关系。产后母亲（≤12 个月；N=500）在完成 PSAS 的同时，还完成了对主观分娩满意度和客观产科干预/并发症的测量。验证性因子分析（CFA）测试了八个模型，这些模型是从之前的探索性工作中理论推导出来的。结构方程模型（SEM）测试了在最佳拟合模型中，每个 PSAS 因素与分娩经历变量之间的关联。一个相同的 51 项四因素模型很好地拟合了数据。SEM 分析显示，对产时护理质量的较低感知与增加的母亲能力和依恋焦虑、实际婴儿护理焦虑以及婴儿安全和福利焦虑有关。主观压力高和对分娩的负面情绪反应与对母亲身份的心理社会调整焦虑增加有关。新生儿重症监护病房入院与实际婴儿护理焦虑之间存在特定关联；婴儿窒息与婴儿安全和福利焦虑之间存在特定关联。研究结果证实了四因素 PSAS 的结构和收敛效度，以及其在测量产后焦虑方面的应用。还发现了特定的关联，表明分娩期间发生的特定主观和客观经历可能会引起不同的焦虑反应，因为它们与产后第一年发生的特定形式的产后焦虑有关。
