Zeng Tieying, Jiang Lingjun, Zhang Ke, Wu Meiliyang, Zhu Zining, Hu Zhenjing
Department of Nursing, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
School of Nursing, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
Front Psychol. 2024 Jan 5;14:1320132. doi: 10.3389/fpsyg.2023.1320132. eCollection 2023.
Psychological birth trauma has been associated with a variety of negative consequences for mothers, partners, newborns, and midwives. While prior research has identified demographic and clinical factors that may contribute to the development of psychological birth trauma, interventions targeting these factors can prove challenging. Therefore, the aim of this study was to explore how psychological birth trauma is influenced by psychosocial factors including Sense of Coherence, Childbirth-related Fear, Social Support and Childbirth Readiness.
A cross-sectional study was conducted in 13 tertiary or secondary hospitals in mainland China from November 2021 to June 2022. One thousand three hundred and sixty-six women were recruited totally. Data regarding basic characteristics, Sense of Coherence (SOC, Sense of Coherence Scale-3), Childbirth-related Fear (CBRF, Fear of Childbirth Scale), Social Support (SS, Medical Outcomes Study Social Support Survey), Childbirth Readiness (CR, Childbirth Readiness Scale) and Psychological Birth Trauma (PBT, Psychological Birth Trauma Scale) were collected. Parallel mediation analysis was adopted to identify the underlying mechanisms between study variables.
It was found that: (1) SOC has been found to have both direct and indirect effects on PBT. Women with higher level of SOC tend to report lower level of PBT; (2) the indirect effect of SOC on PBT was significantly exerted through CBRF, SS and CR; (3) CBRF was found to weaken the protective effect of SOC, whereas SS and CR were found to enhance it. No significant difference was found in contracts of the three specific indirect effects.
SOC, CBRF, SS, and CR should be paid enough attention when designing intervention programs for women who might experience PBT. Interventions targeting SOC and CR are more likely to yield positive outcomes.
心理性分娩创伤与母亲、伴侣、新生儿和助产士的各种负面后果相关。虽然先前的研究已经确定了可能导致心理性分娩创伤发生的人口统计学和临床因素，但针对这些因素的干预措施可能具有挑战性。因此，本研究的目的是探讨心理性分娩创伤如何受到心理社会因素的影响，这些因素包括连贯感、分娩相关恐惧、社会支持和分娩准备度。
2021年11月至2022年6月，在中国大陆的13家三级或二级医院进行了一项横断面研究。共招募了1366名女性。收集了有关基本特征、连贯感（SOC，连贯感量表-3）、分娩相关恐惧（CBRF，分娩恐惧量表）、社会支持（SS，医学结局研究社会支持调查）、分娩准备度（CR，分娩准备度量表）和心理性分娩创伤（PBT，心理性分娩创伤量表）的数据。采用平行中介分析来确定研究变量之间的潜在机制。
研究发现：（1）连贯感对心理性分娩创伤既有直接影响，也有间接影响。连贯感水平较高的女性往往报告较低水平的心理性分娩创伤；（2）连贯感对心理性分娩创伤的间接影响通过分娩相关恐惧、社会支持和分娩准备度显著发挥作用；（3）分娩相关恐惧被发现会削弱连贯感的保护作用，而社会支持和分娩准备度则会增强这种作用。三种特定间接效应的对比未发现显著差异。
在为可能经历心理性分娩创伤的女性设计干预方案时，应充分关注连贯感、分娩相关恐惧、社会支持和分娩准备度。针对连贯感和分娩准备度的干预措施更有可能产生积极效果。
