焦虑、自我效能感与分娩恐惧在初产与经产妇女间的差异及相关性分析  

Differences and intrinsic relationships between anxiety,self-efficacy,and fear of childbirth in primiparous and multiparous women

作　　者：何娜[1,2] 马喜杰 张锐 李密 傅颖[1] HE Na;MA Xijie;ZHANG Rui(Qilu Hospital of Shandong University,Obstetrics Department,Jining 250012,China)

机构地区：[1]山东大学齐鲁医院产科,济宁250012 [2]山东大学护理与康复学院

出　　处：《国际精神病学杂志》2025年第1期177-180,223,共5页Journal Of International Psychiatry

摘　　要：目的 比较初产与经产妇在分娩恐惧、焦虑及自我效能感方面的差异并研究其内在关系。方法 选取2022年1月~2022年12月本院产妇181例,其中包括初产妇68例和经产妇113例,比较初产妇和经产妇的分娩恐惧、焦虑及自我效能感差异,工具分别为分娩恐惧量表(Childbirth Fear Scale,CAQ)、焦虑自评量表(Self-Rating Anxiety Scale,SAS)、分娩自我效能量表(Childbirth Self-Efficacy Inventory,CSEI),并采用Pearson相关性分析探讨初产与经产妇分娩恐惧、焦虑及自我效能感的内在关联。结果 与经产妇比较,初产妇对医院干预与环境的恐惧、对疼痛伤害的恐惧、对分娩时失去控制的恐惧、对孩子健康的恐惧评分及CAQ总分、SAS评分更高(P<0.05)。与经产妇比较,初产妇自我效能期望、结果期望评分及CSEI总分更低(P<0.05)。线性回归发现SAS评分与初产妇和经产妇的分娩恐惧显著正相关(P<0.05),CSEI总分与初产妇和经产妇的分娩恐惧显著负相关(P<0.05)。Bootstrap法检验焦虑对分娩恐惧的影响,结果显示初产妇中,自我效能感的中介效应显著(间接效应0.517,占总效应24.96%);但在经产妇中,该中介效应不显著(间接效应0.086,占总效应9.98%)。结论 与经产妇相比较,初产妇具有更高的分娩恐惧和分娩焦虑,自我效能感更低,分娩焦虑、自我效能感会影响初产妇和经产妇的分娩恐惧,且自我效能感在初产妇焦虑对分娩恐惧的影响中起中介作用。Objective Compare the fear,anxiety,and self-efficacy of childbirth between primiparous and multiparous women.Methods From January 2022 to December 2022,181 parturients were selected,including 68 primiparous and 113 multiparous women,to compare the fear,anxiety,and self-efficacy of childbirth between primiparous and multiparous women.The tools used were the Childbirth Fear Scale(CAQ),Self Rating Anxiety Scale(SAS),and Childbirth Self Efficacy Scale(CSEI).Pearson analysis was used to examine the correlation between fear,anxiety,and self-efficacy of childbirth in primiparous and multiparous women.Results Compared with multiparous women,primiparous women have higher scores in fear of hospital intervention and environment,fear of pain and injury,fear of losing control during delivery,fear of child health,CAQ total score,and SAS score(P<0.05).Compared with multiparous women,primiparous women had lower self-efficacy expectations,outcome expectation scores,and CSEI total scores(P<0.05).Linear regression showed that the SAS score positively associated with the fear of childbirth in primiparous and multiparous women(P<0.05),while CSEI total score negatively associated with the fear of childbirth in primiparous and multiparous women(P<0.05).Bootstrap test showed that among primiparous women,the mediating effect of self-efficacy was significant(indirect effect 0.517,accounting for 24.96%of the total effect);Among multiparous women,the mediating effect was not significant(indirect effect 0.086,accounting for 9.98%of the total effect).Conclusion Compared with multiparous women,primiparous women have higher childbirth fear and anxiety,lowerself-efficacy,and childbirth anxiety. Self efficacy affects the childbirth fear of primiparous and multiparous women,and plays a mediating role in the impact of primiparous anxiety on childbirth fear.

关 键 词：初产妇 经产妇 分娩恐惧 焦虑 自我效能 

分 类 号：R749.99[医药卫生—神经病学与精神病学]