胎儿畸形孕妇堕胎前抑郁症状与堕胎耻辱感的作用及通路。
Effect and pathway of abortion stigma on depressive symptoms before terminating the pregnancy in pregnant women with fetal anomaly.
机构信息
Nursing Department, Third Xiangya Hospital, Central South University, Changsha 410013.
Xiangya Nursing School, Central South University, Changsha 410013.
出版信息
Zhong Nan Da Xue Xue Bao Yi Xue Ban. 2023 Mar 28;48(3):435-443. doi: 10.11817/j.issn.1672-7347.2023.220327.
OBJECTIVES
To explore the effect and pathway of abortion stigma on depressive symptoms before terminating the pregnancy in pregnant women with fetal anomaly.
METHODS
Based on literature review, a self-made general demographic information questionnaire, the Edinburgh Postnatal Depression Scale, the Individual Level Abortion Stigma Scale, the Acceptance and Action Questionnaire-II, the Cognitive Fusion Questionnaire-Fusion, the Responses to Stress Questionnaire and the Perceived Social Support Scale were used to investigate pregnant women with fetal anomaly before abortion in tertiary general hospitals and specialist maternity hospitals in Changsha, to develop a hypothesis model of the factors influencing depressive symptoms before terminating the pregnancy. The hypothesis model was verified by applying structural equation modelling analysis.
RESULTS
The structural equation model showed that the stigma directly or indirectly influenced depressive symptoms before terminating the pregnancy via psychological flexibility, social support and avoidance coping. The total effect value was 0.55 (<0.05), the direct effect value was 0.22 (<0.05), and the indirect effect value was 0.33 (<0.05). Psychological flexibility and social support had protective mediating effects, while avoidance coping had harmful mediating effects.
CONCLUSIONS
Abortion stigma has large positive effect on the depressive symptoms before terminating the pregnancy in pregnant women with fetal anomaly. Among direct and indirect effect, the indirect effect is major. Effective measures to reduce the stigma, increase psychological flexibility, improve social support and coping style will have an important influence on the prevention and reduction of depressive symptoms before terminating the pregnancy.
目的
探讨胎儿畸形孕妇终止妊娠前堕胎耻辱感对抑郁症状的影响及其作用途径。
方法
基于文献回顾，采用自制一般人口学资料问卷、爱丁堡产后抑郁量表、个体层面堕胎耻辱感量表、接纳与行动问卷-II、认知融合问卷融合、应对压力问卷和感知社会支持量表，对长沙市 3 家三级综合医院和专科医院的胎儿畸形孕妇进行调查，构建影响终止妊娠前抑郁症状的因素假设模型。采用结构方程模型分析对假设模型进行验证。
结果
结构方程模型显示，耻辱感通过心理灵活性、社会支持和回避应对间接或直接影响终止妊娠前的抑郁症状。总效应值为 0.55（<0.05），直接效应值为 0.22（<0.05），间接效应值为 0.33（<0.05）。心理灵活性和社会支持具有保护中介作用，而回避应对具有有害中介作用。
结论
胎儿畸形孕妇终止妊娠前堕胎耻辱感对抑郁症状有较大的正向影响，在直接和间接效应中，间接效应占主导地位。采取有效措施减少耻辱感、提高心理灵活性、改善社会支持和应对方式，将对预防和减少终止妊娠前的抑郁症状产生重要影响。
Zotero 插件