The University of Texas at Austin, School of Nursing, Austin, Texas.
J Midwifery Womens Health. 2024 Sep-Oct;69(5):746-754. doi: 10.1111/jmwh.13641. Epub 2024 May 23.
A critical gap exists in understanding stressors and coping that affect women's health beyond 6 weeks postpartum. Using new stressor and coping scales tailored to postpartum women, we examined the relationship of postpartum-specific stressors and coping to women's physical and mental health between 2 to 22 months after childbirth.
A total of 361 women of diverse race, ethnicity, and functional abilities recruited through clinical and online methods completed online surveys that included Sources of Stress-Revised subscales, such as overload, changes after pregnancy, and low support resources; Postpartum Coping Scale subscales, such as self-regulation, self-care, and health promotion; Patient-Reported Outcomes Measurement Information System Global Health, covering physical and mental health dimensions; and social demographic items. Analyses included hierarchical linear regression models adjusted for social factors.
Education and employment were the only social factors associated with physical and mental health, respectively. After adjusting for social factors, overload (P < .001) and coping through health promotion (P = .020) were the only additional variables associated with physical health. After adjusting for social factors, overload (P < .001) and low support resources (P = .002) and coping through self-care (P = .036) were the only additional variables associated with mental health. Thus, being overloaded was the key stressor associated with decreases in physical and mental health. Health promotion was associated with increases in physical health, and self-care was associated with increases in mental health.
These findings point to directions for health care and community interventions to promote health for postpartum women under stress. Strengths of our study include application of stress and coping scales tailored to postpartum women, whereas a limitation is use of a cross-sectional design.
目前，我们对于产后 6 周后影响女性健康的压力源和应对方式知之甚少。本研究使用专门针对产后女性的新压力源和应对方式量表，调查了产后特定压力源和应对方式与产后 2 至 22 个月女性身心健康之间的关系。
我们共招募了 361 名来自不同种族、族裔和功能能力的女性，通过临床和在线方法完成了在线调查，其中包括修订后的压力源量表（如超负荷、怀孕后变化和低支持资源）和产后应对量表（如自我调节、自我保健和健康促进）的子量表、患者报告的结局测量信息系统（PROMIS）全球健康量表（涵盖身体和心理健康维度）以及社会人口统计学项目。分析包括调整社会因素的分层线性回归模型。
教育和就业是唯一与身心健康相关的社会因素。在调整社会因素后，超负荷（P < 0.001）和通过健康促进进行应对（P = 0.020）是与身体健康相关的唯一其他变量。在调整社会因素后，超负荷（P < 0.001）、低支持资源（P = 0.002）和通过自我保健进行应对（P = 0.036）是与心理健康相关的唯一其他变量。因此，超负荷是与身心健康下降相关的关键压力源。健康促进与身体健康的增加相关，自我保健与心理健康的增加相关。
这些发现为医疗保健和社区干预措施指明了方向，以促进处于压力下的产后女性的健康。本研究的优势在于应用了专门针对产后女性的压力源和应对方式量表，而局限性在于使用了横断面设计。
