孕產(chǎn)婦心理變化特征及影響因素分析
發(fā)布時間：2018-11-28 17:09
【摘要】：目的 個體的心理健康始于孕期的論點得到越來越多的認同,因此,對孕婦心理健康及其變化規(guī)律的研究探索也越來越急迫。本文旨在分析不同孕期及產(chǎn)后婦女的心理變化規(guī)律及其社會—文化—家庭影響因素,以便及時有效的開展孕期心理衛(wèi)生保健和針對性的心理干預。 方法 用SCL-90評價孕產(chǎn)婦的情緒狀態(tài),用EPQ來評價其人格特征,使用孕婦臨床結(jié)構(gòu)訪談法來評估分析其社會-文化-家庭影響因素,運用spearman相關(guān)法、Kruskal-Wallis Test與非條件Logistic回歸分析等統(tǒng)計方法,探索不同孕產(chǎn)婦心理狀態(tài)變化特點、規(guī)律以及影響因素。 結(jié)果 1.處于孕中期的婦女其年齡與SCL-90測試結(jié)果呈顯著相關(guān);孕婦心理健康狀況組間比較:26～30歲、31～35歲組好于20～25歲、36～41歲組。孕婦;孕婦的學歷與其SCL-90測試結(jié)果在焦慮、精神病性癥狀等因子上呈顯著相關(guān),經(jīng)Kruskal-Wallis H Test,不同學歷組間SCL-90測試結(jié)果平均秩次排序有以下趨勢:碩士生組大學生組高中生組初中生組。 2. EPQ各維度均與SCL-90總均分呈顯著相關(guān),孕婦根據(jù)EPQ的N維度分組其SCL-90各因子組間得分均存在差異,結(jié)論具統(tǒng)計學意義;不同文化程度組在P維度、E維度達到統(tǒng)計學差異。 3.早孕組、中孕組、晚孕組和產(chǎn)后組之間,在總分、軀體化、人際關(guān)系敏感、抑郁、焦慮、敵對、恐怖和精神病性癥狀等因子上,組間統(tǒng)計學差異顯著(P均0.05);其中軀體化、人際關(guān)系敏感等2項以早孕組最高,總分、抑郁、焦慮、敵對、恐怖、精神病性癥狀等5項以中孕組最高,晚孕組和產(chǎn)后組均較低。非條件Logistic回歸分析顯示,孕婦年齡、文化水平、當前身體感受、對工作學習影響、擔心胎兒畸形等項目均進入回歸方程(P均0.05),年齡、文化水平的OR值依次為0.929、0.780,且OR值均小于1,為孕婦心理健康的保護因素;當前身體感受、對自己工作與學習有影響、擔心胎兒畸形等OR值依次為1.260、1.208、1.259,且OR值均大于1,是孕婦心理健康的危險因素,其中對情緒影響最大的是擔心胎兒畸形,Wald值為6.495。 結(jié)論 1.孕中期婦女存在較高的負性情緒陽性;其心理健康狀況按年齡分布呈中間高兩頭低趨勢,即25歲以前和35歲以后其心理健康水平下降;此外,低學歷的孕婦更有可能出現(xiàn)焦慮、精神病性癥狀等。 2. EPQ可試用于預測婦女圍產(chǎn)期情緒狀態(tài),文化程度較高孕婦的人格特征更可能傾向于外向以及有較低的精神質(zhì)值。 3.懷孕婦女在不同孕期均有某些心理狀態(tài)變化以及負性情緒體驗,但不同孕期各有其特點;社會-文化-家庭等因素對孕婦心理狀態(tài)變化具有不同的影響。
[Abstract]:Objective the argument that individual mental health begins during pregnancy is more and more accepted. Therefore, it is more and more urgent to study the mental health and its changing law of pregnant women. The purpose of this paper is to analyze the psychological changes of women in different pregnancy and postpartum period and the influence factors of sociocultural family, so as to carry out mental health care and psychological intervention in time and effectively. Methods SCL-90 was used to evaluate the emotional status of pregnant women, EPQ was used to evaluate their personality characteristics, and clinical structure interviews were used to evaluate and analyze the sociocultural and family influencing factors of pregnant women. Spearman correlation method was used to evaluate the emotional status of pregnant women. Statistical methods such as Kruskal-Wallis Test and conditional Logistic regression analysis were used to explore the characteristics, rules and influencing factors of mental state of different pregnant and parturient women. Result 1. The age of women in the second trimester of pregnancy was significantly correlated with the results of SCL-90 test, and the mental health status of pregnant women was significantly higher than that of 2025 years old and 360-41 years old group, and the mental health status of pregnant women was 2630 years old, 31 ~ 35 years old group was better than 20 ~ 25 years old group. Pregnant women; The educational background of pregnant women was significantly correlated with their SCL-90 test results in anxiety, psychotic symptoms and other factors. Kruskal-Wallis H Test,. The average rank ranking of SCL-90 test results among different education groups showed the following trends: master students group, university students group, high school students group, junior high school students group. 2. All the dimensions of EPQ were significantly correlated with the total mean score of SCL-90. There were significant differences in the scores of each factor group of SCL-90 among the pregnant women according to the N dimension of EPQ. In P dimension and E dimension, there were statistical differences in different education level groups. 3. There were significant differences in the total score, somatization, interpersonal sensitivity, depression, anxiety, hostility, phobia and psychotic symptoms between the early pregnancy group, the middle pregnancy group, the late pregnancy group and the postpartum group (all P 0.05). Somatization, interpersonal sensitivity were the highest in the early pregnancy group, total score, depression, anxiety, hostility, phobia, psychotic symptoms were the highest in the middle pregnancy group, and lower in the late pregnancy group and postpartum group. Non-conditional Logistic regression analysis showed that pregnant women's age, education level, current physical feeling, influence on work and study, fear of fetal malformation and so on all entered the regression equation (P0. 05), age, etc. The OR value of education level was 0.929 鹵0.780, and the OR value was less than 1, which was the protective factor of pregnant women's mental health. The current physical feeling has an effect on one's own work and study. The OR value of worrying about fetal malformation is 1.260 / 1.208 / 1.259, and the OR value is more than 1, which is a risk factor for the mental health of pregnant women. Among them, the biggest emotional impact is worried about fetal malformation, the Wald value is 6.495. Conclusion 1. In the second trimester of pregnancy, there was a high negative emotion positive, and the mental health status showed a high and low trend according to the age distribution, that is, the mental health level decreased before 25 years old and after 35 years old. In addition, low-educated pregnant women are more likely to develop anxiety, psychiatric symptoms and so on. 2. EPQ can be used to predict the emotional state of women during perinatal period. The personality characteristics of pregnant women with higher education level are more likely to be extroverted and have lower psychoticism. 3. Pregnant women have some changes in mental state and negative emotional experience in different pregnancy, but different pregnancy have their own characteristics, social, cultural and family factors have different effects on the changes of psychological state of pregnant women.
【學位授予單位】：第四軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R395.1
本文編號：2363640
[Abstract]:Objective the argument that individual mental health begins during pregnancy is more and more accepted. Therefore, it is more and more urgent to study the mental health and its changing law of pregnant women. The purpose of this paper is to analyze the psychological changes of women in different pregnancy and postpartum period and the influence factors of sociocultural family, so as to carry out mental health care and psychological intervention in time and effectively. Methods SCL-90 was used to evaluate the emotional status of pregnant women, EPQ was used to evaluate their personality characteristics, and clinical structure interviews were used to evaluate and analyze the sociocultural and family influencing factors of pregnant women. Spearman correlation method was used to evaluate the emotional status of pregnant women. Statistical methods such as Kruskal-Wallis Test and conditional Logistic regression analysis were used to explore the characteristics, rules and influencing factors of mental state of different pregnant and parturient women. Result 1. The age of women in the second trimester of pregnancy was significantly correlated with the results of SCL-90 test, and the mental health status of pregnant women was significantly higher than that of 2025 years old and 360-41 years old group, and the mental health status of pregnant women was 2630 years old, 31 ~ 35 years old group was better than 20 ~ 25 years old group. Pregnant women; The educational background of pregnant women was significantly correlated with their SCL-90 test results in anxiety, psychotic symptoms and other factors. Kruskal-Wallis H Test,. The average rank ranking of SCL-90 test results among different education groups showed the following trends: master students group, university students group, high school students group, junior high school students group. 2. All the dimensions of EPQ were significantly correlated with the total mean score of SCL-90. There were significant differences in the scores of each factor group of SCL-90 among the pregnant women according to the N dimension of EPQ. In P dimension and E dimension, there were statistical differences in different education level groups. 3. There were significant differences in the total score, somatization, interpersonal sensitivity, depression, anxiety, hostility, phobia and psychotic symptoms between the early pregnancy group, the middle pregnancy group, the late pregnancy group and the postpartum group (all P 0.05). Somatization, interpersonal sensitivity were the highest in the early pregnancy group, total score, depression, anxiety, hostility, phobia, psychotic symptoms were the highest in the middle pregnancy group, and lower in the late pregnancy group and postpartum group. Non-conditional Logistic regression analysis showed that pregnant women's age, education level, current physical feeling, influence on work and study, fear of fetal malformation and so on all entered the regression equation (P0. 05), age, etc. The OR value of education level was 0.929 鹵0.780, and the OR value was less than 1, which was the protective factor of pregnant women's mental health. The current physical feeling has an effect on one's own work and study. The OR value of worrying about fetal malformation is 1.260 / 1.208 / 1.259, and the OR value is more than 1, which is a risk factor for the mental health of pregnant women. Among them, the biggest emotional impact is worried about fetal malformation, the Wald value is 6.495. Conclusion 1. In the second trimester of pregnancy, there was a high negative emotion positive, and the mental health status showed a high and low trend according to the age distribution, that is, the mental health level decreased before 25 years old and after 35 years old. In addition, low-educated pregnant women are more likely to develop anxiety, psychiatric symptoms and so on. 2. EPQ can be used to predict the emotional state of women during perinatal period. The personality characteristics of pregnant women with higher education level are more likely to be extroverted and have lower psychoticism. 3. Pregnant women have some changes in mental state and negative emotional experience in different pregnancy, but different pregnancy have their own characteristics, social, cultural and family factors have different effects on the changes of psychological state of pregnant women.
【學位授予單位】：第四軍醫(yī)大學
【學位級別】：碩士
【學位授予年份】：2011
【分類號】：R395.1
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